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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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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
Summary This prospective, observational study explored the need for pain‐related unscheduled contact with healthcare services after outpatient surgery. We hypothesised that 10% of outpatients would have pain‐related unscheduled contact with healthcare services, and that the incidence would differ depending on the type of surgical procedure. In total, 905 patients who had undergone one of five common outpatient surgical procedures (knee or shoulder arthroscopy, surgical correction of hallux valgus, laparoscopic cholecystectomy or laparoscopic gynaecological procedures) completed an electronic questionnaire one week and ...
Source: Anaesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
CONCLUSION: intraarticular magnesium sulfate plus Levobupivacain injection is a safe and effective method for post operative pain management after arthroscopic meniscectomy. PMID: 28314555 [PubMed - as supplied by publisher]
Source: Acta Orthopaedica et Traumatologica Turcica - Category: Orthopaedics Authors: Tags: Acta Orthop Traumatol Turc Source Type: research
Publication date: Available online 29 November 2016 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Conclusion: These results demonstrated that blocking two nerves with arthroscopic approach was an excellent pain management method in postoperative period. Accordingly, patients could recover rapidly and patients' satisfaction could be improved.
Source: Indian Journal of Orthopaedics - Category: Orthopaedics Authors: Source Type: research
ConclusionsUntil now, the anesthetic technique for hip arthroscopy has not been well studied. Thus, increasing emphasis should be directed towards examining relevant clinical outcomes that can better inform evidence-based decision-making in the anesthetic management of hip arthroscopy patients. In the meantime, awareness of potential complications and vigilant monitoring are paramount in providing safe anesthetic care for patients undergoing hip arthroscopy.
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research
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