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Pre- or postoperative interscalene block and/or general anesthesia for arthroscopic shoulder surgery: a retrospective observational study

AbstractPurposeArthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery.MethodsCharts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre-vs postoperative ISBPB combined with GA (ISBPB  + GA [n = 72]vs GA  + ISBPB [n = 52], respectively). The primary outcome measure was the time to discharge from the postanesthesia care unit (PACU).ResultsMean (SD) time in the PACU ranged from 70.5 (39.9) min for ISBPB only to 111.2 (56.9) min for GA only. Use of ISBPB in any combination and regardless of timing resulted in significantly reduced PACU time, with a mean drop of 27.2 min (95% confidence interval [CI], 17.3 to 37.2;P 
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research
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Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Discussion No significant difference in postoperative recovery was observed between groups. Nevertheless, pain management and patient information for outpatients need improving.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Abstract Frozen shoulder is a painful debilitating condition which can be diagnosed clinically. It is a condition of chronic inflammation and proliferative fibrosis resulting in painful limitation of shoulder movements with classical clinical signs. Diabetic patients are more likely to develop the disease and more likely to require operative management. Diabetic frozen shoulder is a difficult condition to manage, and the clinician must strike a balance between improving range of movement and treating pain, but not over-treating what is an essentially self-resolving condition. Treatment options principally include physiothe...
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
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Source: Orthopedics - Category: Orthopaedics Authors: Tags: Orthopedics Source Type: research
ConclusionThe novel combination of a superficial cervical plexus block, a suprascapular nerve block, and an infraclavicular nerve block provides an alternative anesthetic modality for arthroscopic shoulder surgery.
Source: Acta Anaesthesiologica Scandinavica - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Abstract PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISB...
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Condition:   Management of Post-operative Pain in Arthroscopic Shoulder Surgery. Causes and Consequences of Diaphragmatic Paralysis Associated With Regional Anesthesia Intervention:   Procedure: diaphragmatic assessment using ultrasounds. Sponsor:   Clinique Medipole Garonne Not yet recruiting - verified June 2017
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusion Intraarticular administration of magnesium sulphate is found to be better than Intravenous magnesium and intrathecal in postoperative analgesia.
Source: Egyptian Journal of Anaesthesia - Category: Anesthesiology Source Type: research
Authors: Jaffe JD, Morgan TR, Russell GB Abstract Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumpt...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
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