New Insights of Anesthesia for Shoulder Surgery

Alain Borgeat

《Journal of Medical Sciences》 27卷2期 (2007/04) Pp. 47-53

https://doi.org/10.6136/JMS.2007.27(2).047

並列摘要

Early and efficient rehabilitation is a new and widely accepted necessity to improve the success of shoulder surgery. Pain, which is severe to very severe in this condition, is the main factor limiting early rehabilitation. The modified lateral technique is, in our opinion, the safest approach to perform interscalene block. The occurrence of severe complications, such as spinal or epidural anesthesia for example, is reduced as compared to the classic Winnie's approach. Moreover, the insertion of a catheter is more difficult with the latter technique. Performance of the block in an awake or lightly sedated patient with a shortbevelled needle and the aid of a nerve stimulator, will increase the safety of the procedure. After shoulder surgery, regional analgesia provided through an interscalene catheter is a simple, better and safer technique than iv. PCA with morphine. The interscalene catheter seems not to increase the incidence of complications and patients' acceptance and satisfaction are greater than with any other analgesic techniques. Thus, continuous interscalene anesthesia/analgesia should have a place of first choice in the armamentarium of those anesthesiologists involved in the management of shoulder surgery.

並列關鍵字

Shoulder surgery ； Interscalene block ； Modified lateral technique ； Postoperative analgesia