Anesthesia for the Patient Undergoing Shoulder Surgery
Shoulder surgery introduces important anesthesia considerations. The interscalene nerve block is considered the gold standard regional anesthetic technique and can serve as the primary anesthetic or can be used for postoperative analgesia. Phrenic nerve blockade is a limitation of the interscalene block and various phrenic-sparing strategies and techniques have been described. Patient positioning is another important anesthetic consideration and can be associated with significant hemodynamic effects and position-related injuries. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Jeffrey J. Mojica, Aaron Ocker, Jaime Barrata, Eric S. Schwenk Source Type: research
Safety Considerations for Outpatient Arthroplasty
Since 2018, the number of total joint arthroplasties (TJAs) performed on an outpatient basis has dramatically increased. Both surgeon and anesthesiologist should be aware of the implications for the safety of outpatient TJAs and potential patient risk factors that could alter this safety profile. Although smaller studies suggest that the risk of negative outcomes is equivalent when comparing outpatient and inpatient arthroplasty, larger database analyses suggest that, even when matched for comorbidities, patients undergoing outpatient arthroplasty may be at increased risk of surgical or medical complications. Appropriate p...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Alberto E. Ardon Source Type: research
Regional Anesthesia Complications and Contraindications
Regional anesthesia has a strong role in minimizing post-operative pain, decreasing narcotic use and PONV, and, therefore, speeding discharge times. However, as with any procedure, regional anesthesia has both benefits and risks. It is important to identify the complications and contraindications related to regional anesthesia, which patient populations are at highest risk, and how to mitigate those risks to the greatest extent possible. Overall, significant complications secondary to regional anesthesia remain low. While a variety of different regional anesthesia techniques exist, complications tend to fall within 4 broad...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Danial Shams, Kaylyn Sachse, Nicholas Statzer, Rajnish K. Gupta Source Type: research
A Look Forward and a Look Back
The success of enhanced recovery after surgery (ERAS) protocols in improving patient outcomes and reducing costs in general surgery are widely recognized. ERAS guidelines have now been developed in orthopedics with the following recommendations. Preoperatively, patients should be medically optimized with a focus on smoking cessation, education, and anxiety reduction. Intraoperatively, using multimodal and regional therapies like neuraxial anesthesia and peripheral nerve blocks facilitates same-day discharge. Postoperatively, early nutrition with appropriate thromboprophylaxis and early mobilization are essential. As the ev...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Marissa Weber, Melissa Chao, Simrat Kaur, Bryant Tran, Anis Dizdarevic Source Type: research
Regional Anesthesia in the Elite Athlete
This article aims to review the data behind this concern, discuss strategies to improve the safety of these procedures and explore the features of consent in this patient population. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Patrick Meyer, Kristopher Schroeder Source Type: research
Unique Medical Considerations for the Athlete Undergoing Anesthesia
Athletes are among a unique group such that they may possess a serious underlying pathologic condition that may often go unnoticed given their high caliber of physical fitness. However, several considerations should be investigated, especially in the perioperative period, in order to minimize morbidity and mortality. Namely, cardiac pathologic condition can result in sudden death, and pulmonary pathologic condition may affect airway and respiratory management. Moreover, patients undergoing orthopedic surgery are at the highest risk for venous thromboembolism. Regardless of the condition, it is crucial to be vigilant and ex...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Alessandra Riccio, Ashley M. Shilling Source Type: research
Anesthesia for the Patient Undergoing Foot and Ankle Surgery
Modern anesthetic management for foot and ankle surgery includes a variety of anesthesia techniques including general anesthesia, neuraxial anesthesia, or MAC in combination with peripheral nerve blocks and/or multimodal analgesic agents. The choice of techniques should be tailored to the nature of the procedure, patient comorbidities, anesthesiologist skill level, intensity of anticipated postoperative pain, and surgeon preference. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Christopher M. Sharrow, Brett Elmore Source Type: research
Continuous Catheter Techniques
Continuous peripheral nerve block catheters are simple in concept: percutaneously inserting a catheter adjacent to a peripheral nerve. This procedure is followed by local anesthetic infusion via the catheter that can be titrated to effect for extended anesthesia or analgesia in the perioperative period. The reported benefits of peripheral nerve catheters used in the surgical population include improved pain scores, decreased narcotic use, decreased nausea/vomiting, decreased pruritus, decreased sedation, improved sleep, and improved patient satisfaction. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Brittany Deiling, Kenneth Mullen, Ashley M. Shilling Source Type: research
Local Anesthetics, Local Anesthetic Systemic Toxicity (LAST), and Liposomal Bupivacaine
Local anesthetics have played a vital role in the multimodal analgesia approach to patient care by decreasing the use of perioperative opioids, enhancing patient satisfaction, decreasing the incidence of postoperative nausea and vomiting, decreasing the length of hospital stay, and reducing the risk of chronic postsurgical pain. The opioid-reduced anesthetic management for perioperative analgesia has been largely successful with the use of local anesthetics during procedures such as peripheral nerve blocks and neuraxial analgesia. It is important that practitioners who use local anesthetics are aware of the risk factors, p...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Michael O. On'Gele, Sara Weintraub, Victor Qi, James Kim Source Type: research
Anesthesia for Athletes
This issue of Clinics in Sports Medicine is not a pain, reaches well beyond a regional focus, and it won ’t put you to sleep! Although we often like to kid each other, Surgeons and Anesthesiologist are co-captains of the surgical team—we can’t do our jobs without each other. Because athletes often present unique challenges to our anesthesia colleagues, I thought it was important to dedicate an is sue of Clinics in Sports Medicine to this important topic. Therefore, I asked my “go-to” anesthesiologist (who I have also gone to for more than one surgery), Dr Ashley Shilling, to put together this issue that focuses o...
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Mark D. Miller Tags: Foreword Source Type: research
Pulling Down the Surgical Drape Between the Anesthesiologist and the Orthopedic Surgeon …
Since the first public demonstration of modern anesthesia in 1846, the field of anesthesiology has played a crucial role in all surgical specialties. The first spinal anesthetic (using cocaine) was performed in 1898 by August Bier, also the founder of the Bier block so frequently used in orthopedic surgery. Clearly, we have come a long way since cocaine spinals or even week-long admissions following anterior cruciate ligament surgery. Orthopedic anesthesia has evolved into an eloquent specialty that is efficient, safe, and evidence based. (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Ashley M. Shilling Tags: Preface Source Type: research
Sports Anesthesia
CLINICS IN SPORTS MEDICINE (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Authors: Ashley M. Shilling Source Type: research
Copyright
ELSEVIER (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
Contributors
MARK D. MILLER, MD (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
Contents
Mark D. Miller (Source: Clinics in Sports Medicine)
Source: Clinics in Sports Medicine - March 15, 2022 Category: Sports Medicine Source Type: research
