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Continuing Education in Anaesthesia, Critical Care & Pain 2008 8(6):193-198; doi:10.1093/bjaceaccp/mkn040
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© The Board of Management and Trustees of the British Journal of Anaesthesia [2008]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Anaesthesia for shoulder surgery

Christina L. Beecroft, FRCA, FDS RCS
Department of Anaesthetics
Ninewells Hospital and Medical School
Dundee DD1 9SY
UK

David M. Coventry, FRCA
Department of Anaesthetics
Ninewells Hospital and Medical School
Dundee DD1 9SY
UK
E-mail: david.coventry@nhs.net

The first 150 words of the full text of this article appear below.


Key points

Severe pain following shoulder surgery is common and remains a major challenge.
Regional anaesthetic techniques have the ability to control pain effectively, both at rest and on movement, allowing earlier mobilization.
Sound anatomical knowledge is the key to planning and executing successful regional anaesthesia.
Interscalene block should be considered as the regional technique of choice.
The perineural infusion of local anaesthetic can successfully prolong postoperative analgesia.

 

There is a wide variety of patients who present for shoulder surgery, ranging from the fit, robust patient with a sports injury requiring a stabilization procedure, to the frail, elderly rheumatoid patient requiring joint decompression or arthroplasty. Recent surgical advances have resulted in the development of minimal access arthroscopic procedures with resulting improvements in speed of convalescence. However, the management of severe postoperative pain remains a major challenge for many anaesthetists.

Regional anaesthetic techniques have the ability to control pain effectively both . . . [Full Text of this Article]


   Anatomy
 

   Surgical procedures
 
Open surgery

Arthroscopic surgery


   Preoperative assessment
 
General considerations

Rheumatoid disease


   Interscalene blockade
 

   Intraoperative management
 

   Postoperative analgesia
 
Oral and parenteral analgesia

Single-shot nerve block techniques

Catheter techniques

Intra-articular analgesia

Suprascapular nerve block

Choice of technique


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