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ORIGINAL ARTICLE
Year : 2007  |  Volume : 41  |  Issue : 3  |  Page : 230-236

Interscalene brachial plexus block for outpatient shoulder arthroplasty: Postoperative analgesia, patient satisfaction and complications


1 School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
2 The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE; The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
3 The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE, USA
4 The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE; The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina; The Division of Orthopedic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA

Correspondence Address:
Anand Shah
School of Medicine, University of Pennsylvania, 3450 Hamilton Walk, Suite 100, Philadelphia, PA
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5413.33688

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Background: Shoulder arthroplasty procedures are seldom performed on an ambulatory basis. Our objective was to examine postoperative analgesia, nausea and vomiting, patient satisfaction and complications of ambulatory shoulder arthroplasty performed using interscalene brachial plexus block (ISB). Materials and Methods: We prospectively examined 82 consecutive patients undergoing total and hemi-shoulder arthroplasty under ISB. Eighty-nine per cent (n=73) of patients received a continuous ISB; 11% (n=9) received a single-injection ISB. The blocks were performed using a nerve stimulator technique. Thirty to 40 mL of 0.5% ropivacaine with 1:400,000 epinephrine was injected perineurally after appropriate muscle twitches were elicited at a current of less than 0.5% mA. Data were collected in the preoperative holding area, intraoperatively and postoperatively including the postanesthesia care unit (PACU), at 24h and at seven days. Results: Mean postoperative pain scores at rest were 0.8 2.3 in PACU (with movement, 0.9 2.5), 2.5 3.1 at 24h and 2.8 2.1 at seven days. Mean postoperative nausea and vomiting (PONV) scores were 0.2 1.2 in the PACU and 0.4 1.4 at 24h. Satisfaction scores were 4.8 0.6 and 4.8 0.7, respectively, at 24h and seven days. Minimal complications were noted postoperatively at 30 days. Conclusions: Regional anesthesia offers sufficient analgesia during the hospital stay for shoulder arthroplasty procedures while adhering to high patient comfort and satisfaction, with low complications.


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