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Anesthesiological Techniques

  • Fabrizio FattoriniEmail author
  • Alessandro Rocco
Chapter

Abstract

The association of general “light” anesthesia and the peripheral brachial plexus block seems to be the most suitable anesthesiological technique during shoulder prosthesis, both for patients’ needs and surgeon requirements. Even if locoregional anesthesia potentially allows the surgical intervention by itself, its application is likely to be limited by several factors. The intraoperative position assumed by the patient—beach chair or lateral—associated with a prolonged surgical procedure often causes a discomfort that can sometimes require the switch to general anesthesia during intervention. Being general anesthesia for shoulder surgical interventions not different from that adopted in other types of surgery, only locoregional anesthesiological procedures will be described in this chapter. In the last decades, locoregional anesthesia underwent a progressive development, especially in orthopedic surgery: a better safety and analgesia are improved, especially during surgical interventions performed in day surgery setting. Several clinical studies demonstrate the efficacy of peripheral blocks not only for their effective control of intra- and postoperative acute pain but also for their use during the rehabilitation and functional recovery. It is in fact possible to prolong the analgesic effect of peripheral block during postoperative period (continuous nervous blocks) by continuous perineural infusion of local anesthetics. Furthermore, the introduction of ultrasonography to identify nerves makes the peripheral blocks more selective and safer.

Keywords

Locoregional anesthesia Shoulder surgery anesthesiological technique Shoulder pain Shoulder prosthesis anesthesia 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Anesthesia and Intensive Care Medicine, Policlinico Umberto I HospitalSapienza University of RomeRomeItaly

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