Anesthesia and Postoperative Analgesia Methods in Shoulder Surgeries

Year 2023, Volume: 2 Issue: 1, 31 - 36, 30.03.2023

Ahmet Eroğlu

Abstract

There is an increasing interest in shoulder surgery and related anesthesia and analgesia methods. The shoulder is very important for a vertical body position and cosmetic appearance particularly in women. The shoulder joint has the largest motion range of all joints in the human body. All of the shoulder procedures need adequate anesthesia and analgesia for both the comfort of the patients and an early use of rehabilitation exercise. In current clinical practice general anesthesia or nerve blocks like infiltration and interscalene block like upper extremity blocks can be used for shoulder surgeries. When compared the anesthesia and analgesia techniques for shoulder surgery we should consider the effectiveness of pain control, incidence of side effects, and patient satisfaction of the techniques.

Keywords

Anaesthesia, Postorepative Analgesia, Shoulder surgery

Omuz Cerrahilerinde Anestezi ve Postoperatif Analjezi Yöntemleri

Abstract

Omuz cerrahisi ve onunla ilgili anestezi ve analjezi yöntemlerine olan ilgi giderek artmaktadır. Omuz dik vücut pozisyonu ve özellikle bayanlarda estetik görünüm için çok önemlidir. Omuz eklemi insan vücudundaki bütün eklemler içinde en geniş hareket aralığına sahip olan eklemdir. Bütün omuz prosedürleri hem hasta konforu hem de rehabilitasyon egzersizlerinin erkenden yapılabilmesi için yeterli anestezi ve analjeziye gereksinim duymaktadır. Güncel klinik pratikte genel anestezi veya infiltrasyon gibi sinir blokları ve interskalen blok gibi üst ekstremite blokları omuz cerrahilerinde başarıyla kullanılmaktadır. Anestezi ve analjezi tekniklerini omuz cerrahisinde karşılaştırdığımızda tekniğin ağrı kontrolünde etkinliğini, yan etki insidansını ve hasta memnuniyetini göz önüne almalıyız.

Keywords

Anestezi, * Postoperatij analjezi, Omuz cerrahisi

References

• Eroglu A. Single-shot interscalene block with periarticular local infiltration analgesia for shoulder arthroplasty. Minerva Anestesiol. 2019; 85: 812-813. DOI: 10.23736/S0375-9393.19.13910-7.
• Eroglu A. A comparison of patient-controlled subacromial and i.v. analgesia after open acromioplasty surgery. Br J Anaesth. 2006; 96: 497-501. DOI: 10.1093/bja/ael018.
• Mauermann WJ, Shilling AM, Zuo Z. A comparison of neuraxial block versus general anesthesia for elective total hip replacement: a meta-analysis. Anesth Analg. 2006; 103: 1018-1025. DOI: 10.1213/01.ane.0000237267.75543.59.
• Eroglu A, Saracoglu S, Erturk E, Kosucu M, Kerimoglu S. A comparison of intraarticular morphine and bupivacaine for pain control and outpatient status after an arthroscopic knee surgery under a low dose of spinal anaesthesia. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1487-1495. doi:10.1007/s00167-010-1061-0.
• Macfarlane AJR, Prasad GA, Chan VWS, Brull R. Does regional anaesthesia improve outcome after total hip arthroplasty? A systematic review. Br J Anaesth. 2009; 103: 335-345. DOI: 10.1093/bja/aep208.
• Casati A, Borghi B, Fanelli G, et al. Interscalene brachial plexus anesthesia and analgesia for open shoulder surgery: a randomized, double-blinded comparison between levobupivacaine and ropivacaine. Anesth Analg. 2003; 96(1):. doi:10.1097/00000539-200301000-00051.
• Memtsoudis SG, Sun X, Chiu YL, et al. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients [published correction appears in Anesthesiology. 2016 Sep;125(3):610]. Anesthesiology. 2013;118(5):1046-1058. doi:10.1097/ALN.0b013e318286061d.
• Hussain N, Goldar G, Ragina N, Banfield L, Laffey JG, Abdallah FW. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017;127(6):998-1013. doi:10.1097/ALN.0000000000001894.
• Hewson DW, Oldman M, Bedforth NM. Regional anaesthesia for shoulder surgery. BJA Educ. 2019; 19: 98e104. DOI: 10.1016/j.bjae.2018.12.004.
• Eroglu A. A case of transient hoarseness caused by interscalene brachial plexus block in shoulder surgery. Br J Anaesth. 2012; Volume 109, Issue eLetters Supplement, 31 December 2012, DOI:10.1093/bja/el_9494.
• Kettner SC, Willschke H, Marhofer P. Does regional anaesthesia really improve outcome? Br J Anaesth. 2011; 107: i90-i95. DOI: 10.1093/bja/aer340.
• Sermeus LA, Schepens T, Hans GH, et al. A low dose of three local anesthetic solutions for interscalene blockade tested by thermal quantitative sensory testing: a randomized controlled trial. J Clin Monit Comput. 2019;33(2):307-316. doi:10.1007/s10877-018-0150-3.
• Muittari P, Kirvela O. The safety and efficacy of intrabursal oxycodone and bupivacaine in analgesia after shoulder surgery. Reg Anesth Pain Med. 1998; 23: 474-478. DOI: 10.1016/s1098-7339(98)90030-x.
• Muittari PA, Nelimarkka O, Seppala T, Kanto JH, Kirvelä OA. Comparison of the analgesic effects of intrabursal oxycodone and bupivacaine after acromioplasty. J Clin Anesth. 1999; 11: 11–16. DOI: 10.1016/s0952-8180(98)00122-6.
• Borgeat A, Schappi B, Biasca N, Gerber C. Patient-controlled analgesia after major shoulder surgery: PCIA versus PCA. Anesthesiology. 1997; 87: 1343–1347. DOI: 10.1097/00000542-199712000-00013.
• Eroglu A, Uzunlar H, Sener M, Akinturk Y, Erciyes N. A clinical comparison of equal concentration and volume of ropivacaine and bupivacaine for interscalene brachial plexus anesthesia and analgesia in shoulder surgery. Reg Anesth Pain Med. 2004; 29: 539-543. DOI:10.1016/j.rapm.2004.07.224.
• Park JY, Lee GW, Kim Y, Yoo MJ. The efficacy of continuous intrabursal infusion with morphine and bupivacaine for postoperative analgesia after subacromial arthroscopy. Reg Anesth Pain Med. 2002; 27(2): 145-149. doi:10.1053/rapm.2002.31209.
• Kwon W, Lee SM, Bang S. Costoclavicular block for shoulder surgery in a patient with tracheobronchopathia osteochondroplastica and COPD. J Clin Anesth. 2019; 55: 13-14. DOI: 10.1016/j.jclinane.2018.12.032.
• Benjamin D, Gross BD, Paganessi SA, Oscar Vazquez O. Comparison of subacromial injection and interscalene block for immediate pain management after arthroscopic rotator cuff repair. Arthroscopy. 2020; 36: 1243-1250. DOI: 10.1016/j.arthro.2020.01.032.
• Kreutziger J, Hirschi D, Fischer S. Comparison of interscalene block, general anesthesia, and intravenous analgesia for out-patient shoulder reduction. J Anesth. 2019; 33: 279-286. DOI: 10.1007/s00540-019-02624-6.
• Iwashita S, Hashiguchi H, Okubo A, Yoneda M, Takai S. Nerve block for pain relief during arthroscopic rotator cuff repair. J Nippon Med Sch. 2020; 87: 87-91. DOI: 10.1272/jnms.JNMS.2020_87-206.
• El-Boghdadly K, Chin KJ, Chan VWS. Phrenic nerve palsy and regional anesthesia for shoulder surgery. Anatomical, physiologic, and clinical considerations. Anesthesiology. 2017; 127: 173-191. DOI: 10.1097/ALN.0000000000001668.
• Kolade O, Patel K, Ihejirika R, et al. Efficacy of liposomal bupivacaine in shoulder surgery: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2019;28(9):1824-1834. doi:10.1016/j.jse.2019.04.054.
• Abdallah FW, Halpern SH, Aoyama K, Brull R. Will the real benefits of single-shot interscalene block please stand up? A systematic review and meta-analysis. Anesth Analg. 2015; 120: 1114-1129. DOI: 10.1213/ANE.0000000000000688.
• Bojaxhi E, Lumermann LA, Mazer LS, Howe BL, Ortiguera CJ, Clendenen SR. Interscalene brachial plexus catheter versus single-shot interscalene block with periarticular local infiltration analgesia for shoulder arthroplasty. Minerva Anestesiol. 2019; 85(8): 840-845. doi:10.23736/S0375-9393.19.13387-1.
• Erturk E, Kutanis D, Akdogan A, Eroglu A. Emergent Reimplantation of Arm with Interscalene Block. Anesth Pain Res. 2017; 1(1): 1-2. DOI: 10.33425/2639-846X.1003.