shoulder adhesive capsulitis and ambulatory continuous interscalene nerve blocks

Conditions: Adhesive Capsulitis; Post-operative Pain

Summary: research study to determine if putting local anesthetic through a tiny tube next to the nerves that go to the shoulder will improve shoulder range-of-motion following the shoulder procedure performed on the frozen shoulder. it will also help determine if patients have a higher quality-of-life and less pain, require fewer pain pills, experience fewer sleep disturbances, and are more satisfied with their post-procedure pain control.

primary specific aim: to determine if, compared with usual and customary analgesia, the addition of an ambulatory continuous interscalene nerve block will result in increased shoulder abduction following treatment for adhesive capsulitis of the shoulder. hypothesis: following shoulder manipulation under a single-injection interscalene block for adhesive capsulitis, adding a three-day ambulatory continuous interscalene nerve blcok to usual and customary post-manipulation analgesia will result in a significantly greater shoulder abduction improvement the day following the manipulation. secondary specific aims: to determine if, compared with usual and customary analgesia, the addition of an ambulatory continuous interscalene nerve block will result in an increased quality-of-life and shoulder range-of-motion, as well as a decreased chronic pain following treatment for adhesive capsulitis of the shoulder. hypothesis 1: following shoulder manipulation under a single-injection interscalene blcok for adhesive capsulitis, adding a three-day ambulatory continuous interscalene nerve block to usual and customary post-manipulation analgesia will result in a significantly increased quality-of-life improvement and shoulder range-of-motion compared wiht baseline values after three months. hypothesis 2: following shoulder manipulation undera a single-injection interscalene block for adhesive capsulitis, adding a three-day ambulatory continuous interscalene nerve block to usual and costomary post-manipulation analgesia will result in a significantly decreased chronic pain compared with basedline falues after three months.

Eligibility criteria:
inclusion criteria: * undergoing theraputic manipulation for adhesive capsulitis of the shoulder * age 18 years or older * accepting a single-injection nerve block for manipulation * understanding possible perineural infusion-related complications, study protocol, and catheter/pump care * having caretaker through the first night after manipulation * having an asa physical status classification of 1-3 exclusion criteria: * any contraindications for a cisb * any physical, mental or medical conditions which, in the opinion of the investigators, may confound quantifying postoperative pain resulting from surgery * known allergy or other contraindication to the study medications * pregnancy * known hepatic or renal insufficiency/disease * peripheral neuropathy of the surgical extremity * morbid obesity * inability to communicate with the investigators and hospital staff * moderate-to-severe shoulder arthritis * immunocompromised status of any etiology * incarceration

Keywords: ucsd pain quality-of-life range-of-motion interscalene catheter nerve block shoulder shoulder manipulation