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Arthroscopic Shoulder Surgery 

Arthroscopic Shoulder Surgery
Chapter:
Arthroscopic Shoulder Surgery
Author(s):

M. Stephen Melton

, James Kyunghoon Kim

, and Karen C. Nielsen

DOI:
10.1093/med/9780190856649.003.0005
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date: 20 September 2019

Shoulder arthroscopy is an extremely common elective ambulatory surgery procedure that is performed for a multitude of indications. Significant postoperative pain associated with these procedures necessitates an adequate multimodal analgesic plan. Peripheral nerve blockade (PNB) is commonly performed for intraoperative anesthesia and/or postoperative analgesia. This chapter reviews patient- and surgery-specific considerations for outpatient shoulder arthroscopy anesthesia and analgesia. Interscalene block (ISB) is commonly performed PNB for shoulder surgery, although side effects associated with its use have spurred interest in alternative techniques. The safety and efficacy of adjuvants to extend local anesthetic duration achieved with single-injection PNBs for arthroscopic shoulder surgery are still under investigation. As such, extended postoperative analgesia relies on continuous catheter techniques. Appropriate dosing regimens must be employed for both single-injection ISB and continuous interscalene brachial plexus block, and a protocol must be in place for safe, effective discharge and follow-up of patients going home with perineural infusions.

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