| Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting. | |
| | |
MedLine Citation:
|
PMID: 18299092 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND OBJECTIVES: Large prospective studies evaluating continuous interscalene block for shoulder surgery have thus far been limited to inpatient and university teaching practices. Shoulder surgery is increasingly being performed on an outpatient basis. The aim of this case series was to prospectively evaluate a large series of interscalene catheters for ambulatory shoulder surgery in a private practice setting. METHODS: A single operator placed nonstimulating catheters using a combination of ultrasound and nerve stimulation. Following postanesthesia care unit (PACU) discharge, opioid-like analgesic adjuvants other than tramadol were avoided unless patients experienced inadequate pain relief. All patients were assessed in the PACU, on the first postoperative morning, and at 3 weeks for catheter effectiveness and for acute and chronic complications. Pain scores and patient satisfaction were assessed in subgroups of 100 consecutive patients. RESULTS: Three hundred patients were studied. The first attempt catheter success rate was 96%. In all but 1 patient, ineffective catheters in the PACU were effectively reinserted. Thirteen patients experienced inadequate pain relief after leaving the PACU. Of these patients, 5 were rescued with additional ropivacaine, 3 had the catheter effectively reinserted, and 5 were managed with oral opioids. One patient required antibiotic treatment for catheter site infection. Neurological sequelae potentially attributable to the catheter were present in 3 patients at 3 weeks, and remained in 1 patient at 4 weeks. This patient's symptoms resolved at 6 months. CONCLUSIONS: Continuous interscalene block for ambulatory shoulder surgery in a private practice setting had a high success rate, a low complication rate, and enabled the avoidance of the use of potent opioids in 98% of patients. |
| | |
Authors:
|
Michael J Fredrickson; Craig M Ball; Adam J Dalgleish |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Regional anesthesia and pain medicine Volume: 33 ISSN: 1098-7339 ISO Abbreviation: Reg Anesth Pain Med Publication Date: 2008 Mar-Apr |
Date Detail:
|
Created Date: 2008-02-26 Completed Date: 2008-05-20 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: United States |
Other Details:
|
Languages: eng Pagination: 122-8 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand. fredrickson@actrix.co.nz |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Ambulatory Surgical Procedures* Amides / therapeutic use Analgesia, Patient-Controlled Anesthetics, Local / therapeutic use Brachial Plexus* Female Humans Male Middle Aged Nerve Block / methods* Pain Measurement Pain, Postoperative / prevention & control* Patient Satisfaction Private Practice Prospective Studies Shoulder / surgery* |
| Chemical | |
Reg. No./Substance:
|
0/Amides; 0/Anesthetics, Local; 84057-95-4/ropivacaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Isobolographic analysis of epinephrine with bupivacaine, dextromethorphan, 3-methoxymorphinan, or de...
Next Document: Hypotensive epidural anesthesia in patients with aortic stenosis undergoing total hip replacement.