Analgesia for day-case shoulder surgery

Abstract

We conclude that analgesia at home is often inadequate after painful day-case surgical procedures if single-shot local anaesthetic blockade is used.

Day case shoulder surgery: satisfactory pain control without regional anaesthesia. A prospective analysis of a perioperative protocol

“…The majority of patients in our study were highly satisfied with their experience of day case arthroscopic shoulder surgery with 95% saying they would elect to have another one done in a similar manner. Contrary to the published literature that advocates the necessity for regional anaesthesia, stating that analgesia at home is often inadequate [4], our study demonstrates that day case shoulder surgery can be performed safely without it. This can be achieved using adequate oral analgesia in the postoperative period in combination with a SASBB instead.…”

“…Subacromial bursal blocks have also been shown to provide effective, safe, and easily administered postoperative analgesia in patients undergoing arthroscopic subacromial decompression [3]. Our objective was to prospectively study the efficacy of oral analgesia [4] in combination with either a surgeon-administered subacromial bursal block (SASBB) or an anaesthetist-administered interscalene block (AAISB) for postoperative pain in 117 patients undergoing arthroscopic shoulder surgery as a day case. This was based on our hypothesis that satisfactory pain control was possible without the use of regional anaesthesia.…”

Age as a Predictive Factor for In-Patient Admission Following Day-Case Shoulder Arthroscopic Sub-Acromial Decompression – A District General Hospital Audit

“…6,8 Nevertheless, immediate postoperative pain can be a significant problem. 10 With increasing demand to perform more day-case surgery and the reduction in the available number of in-patient ward beds nationally, it is in the interest of hospitals and some patients that these procedures are performed as daycases whenever possible. However, ensuring adequate postoperative pain control is an issue as it is not possible to deliver patient-controlled analgesia safely in an out-patient setting and strong opiates are not routinely prescribed as take-home prescriptions following day-case surgery.…”

Comparison of interscalene brachial plexus block and intra-articular local anesthetic administration on postoperative pain management in arthroscopic shoulder surgery

“…2---5 Inter-scalene brachial plexus block (ISPB) is being widely used for postoperative analgesia in arthroscopic shoulder surgery. 6 However, experience is required to use this technique. Today, although success has increased with the use of ultrasonography in this field and complication rates have been decreased, the success rate is still not 100% and the possibility of serious complications has not been completely prevented.…”