Anaesthesia for shoulder surgery

Abstract

There is a wide variety of patients who present for shoulder surgery, ranging from the fit, robust patient with a sports injury requiring a stabilization procedure, to the frail, elderly rheumatoid patient requiring joint decompression or arthroplasty. Recent surgical advances have resulted in the development of minimal access arthroscopic procedures with resulting improvements in speed of convalescence. However, the management of severe postoperative pain remains a major challenge for many anaesthetists. Regional anaesthetic techniques have the ability to control pain effectively both at rest and on movement, reduce muscle spasm, and allow earlier mobilization and cooperation with physiotherapy. Therefore, these techniques have the potential to improve both patient recovery and outcome after both open and arthroscopic surgeries. Management of these patients requires thorough preoperative assessment, careful intraoperative management, and appropriate use of regional anaesthetic techniques to provide adequate dynamic pain relief in the initial postoperative period.

Ultrasonography‐guided anterior approach for axillary nerve blockade: An anatomical study

“…A wide range of peripheral nerve blockade techniques has been used for pain relief after arthroscopic surgery (Beecroft and Coventry, ; Fredrickson et al, ). The interscalene nerve blockade (ISB) is the most common approach (Winnie, ; Fredrickson et al, ; Abdallah et al, ).…”

A Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery

“…1 To avoid the ISB-associated complications and adverse effects, prior studies have looked into the utility of suprascapular nerve block (SSNB) as an alternative 2 but found inferior quality analgesia. In the uncontrolled retrospective case series, Price 3 has suggested adding axillary nerve block (AXNB) to SSNB for satisfactory analgesia.…”

The assessment of haemodynamic stability, gas exchange parameters, and the quality of postoperative analgesia in patients undergoing arthroscopic shoulder joint surgery in two different types of anaesthesia – preliminary research

“…Intraoperative hypotension can be obtained via two approaches: intravenous medications and peripheral nerve block. Attenuating pain during and after the procedure is a significant issue, which requires the application of an appropriate method of treatment [3][4][5][6][7][8]. Performing an interscalene muscle block of the brachial plexus is a method of regional anaesthesia applied by choice for procedures of the shoulder joint [9,10].…”