Is tingling in fingers a normal side effect after a nerve block for rotator cuff surgery?

From the Guidelines

Tingling in fingers is a normal side effect after a nerve block for rotator cuff surgery, typically lasting 12-24 hours, and is part of the expected recovery process. This sensation occurs because the nerve block medication intentionally affects the nerves that control both sensation and movement in your shoulder, arm, and hand 1. The use of a regional analgesic technique, such as a continuous interscalene block, is recommended as a component of multimodal analgesia for rotator cuff repair surgery, as it provides excellent pain control immediately after surgery while reducing the need for opioid pain medications 1.

Some key points to consider:

• The nerve block medication, such as bupivacaine, ropivacaine, or lidocaine, can cause a tingling sensation in the fingers as it wears off, which is usually temporary and resolves on its own 1.
• If the tingling persists beyond 48-72 hours after surgery, becomes painful, or is accompanied by weakness that doesn't improve, it is essential to contact your healthcare provider, as these symptoms could indicate nerve irritation or injury that requires medical attention.
• The analgesic regimen for rotator cuff repair should include an arthroscopic approach, paracetamol, non-steroidal anti-inflammatory drugs, dexamethasone, and a regional analgesic technique, with opioids as rescue analgesics 1.
• It is crucial to follow the recommended analgesic regimen to ensure optimal pain management and minimize the risk of complications after rotator cuff repair surgery.

From the Research

Tingling in Fingers after Nerve Block for Rotator Cuff Surgery

• Tingling in fingers can be a side effect after a nerve block for rotator cuff surgery, as reported in some studies 2, 3.
• A study published in 2020 found that one patient in the continuous interscalene nerve block group reported temporary paralysis of the fingers and drug solution leakage 2.
• Another study published in 2022 found that 33% of patients reported hand paresthesia before surgery, and there was a 50% and 60% reduction in the severity of hand tingling and numbness, respectively, by 1 week after surgery 3.
• The study also found that the preoperative level of hand numbness and whether the patient's shoulder problem was caused by a specific injury were predictive of the presence of hand numbness at 6 months after surgery 3.

Prevalence and Magnitude of Hand Paresthesia

• Hand paresthesia is a common symptom in patients presenting with rotator cuff tears, with 33% of patients reporting hand paresthesia before surgery 3.
• The prevalence and severity of shoulder pain and hand numbness and tingling improved postoperatively, with a 50% and 60% reduction in the severity of hand tingling and numbness, respectively, by 1 week after surgery 3.

Nerve Block Anesthesia and Postoperative Pain Control

• Nerve block anesthesia has been shown to provide superior same-day recovery over general anesthesia for outpatient rotator cuff surgery 4.
• A systematic review and meta-analysis published in 2022 found that peripheral nerve blocks outperform general anesthesia for pain control in arthroscopic rotator cuff repair, with continuous interscalene brachial plexus nerve block having a significant reduction in pain score relative to general anesthesia at 1-hour postoperation 5.