Skip to main content

Anaesthesia and Analgesia for Shoulder Arthroplasty

  • Conference paper
  • 453 Accesses

Summary

The two techniques of anesthesia for shoulder arthroplasty (general anaesthesia and regional anaesthesia) are not mutually exclusive and can be usefully combined. Advantages, disadvantages and complications of general and regional anaesthesia, used alone or in combination, should be known and are reported in details. Furthermore, the anaesthetist should be aware of adverse cardiovascular effects related to the fact that shoulder replacement is performed in the beach chair position. Shoulder arthroplasty is associated with significant postoperative pain and all the options for analgesia should be familiar to the anaesthetist. Pain management techniques, including brachial plexus blockade, patient-controlled analgesia and brachial plexus catheterisation are also detailed.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Barutell C, Vidal F, Raich M, Montero A (1980) A neurological complication following interscalene brachial plexus block. Anaesth 35:365–367

    Article  CAS  Google Scholar 

  2. Bashein G, Robertson HT, Kennedy WF Jr (1985) Persistent phrenic nerve paresis following interscalene brachial plexus block. Anesthesiology 63:102–104

    Article  PubMed  CAS  Google Scholar 

  3. Baylot D, Mahul P, Navez ML, Hajjar J, Prades JM, Auboyer C (1993) Cervical epidural anesthesia. Ann Fr Anesth Reanim 12:483–492

    Article  PubMed  Google Scholar 

  4. Boogaerts J, Guillaume C, Lafont N (1993) Loco-regional anesthesia for surgery of the shoulder. Cah Anesthesiol 41:173–15

    PubMed  CAS  Google Scholar 

  5. Brandl F, Taeger K (1991) The combination of general anesthesia and interscalene block in shoulder surgery. Anaesthesist 40:537–542

    PubMed  CAS  Google Scholar 

  6. Breen TW, Haigh JD (1990) Continuous suprascapular nerve block for analgesia of scapular fracture. Can J Anaesthesia 37:786–788

    Article  CAS  Google Scholar 

  7. Chambers W (1992) Peripheral nerve damage and regional anaesthesia. Br J Anaesth 69:429–436

    Article  PubMed  CAS  Google Scholar 

  8. Cook LB (1991) Unsuspected extradural catheterization in an interscalene block. Br J Anaesth 67:473–475

    Article  PubMed  CAS  Google Scholar 

  9. D’Alessio JG, Weller RS, Rosenblum M (1995) Activation of the Bezold-Jarisch reflex in the sitting position for shoulder arthroscopy using interscalene block. Anesth Analg 80:1158–1162

    PubMed  Google Scholar 

  10. Davidas JL, Blond JL, Rochette A, Manchom M, Degoute CS, Banssillon V (1992) Local analgesic action by direct effect of pethidine on nerve trunks. Therapie 47:485–487

    PubMed  CAS  Google Scholar 

  11. Dutton RP, Eckhardt WF III, Sunder N (1994) Total spinal anesthesia after interscalene blockade of the brachial plexus. Anesthesiology 80:939–941

    Article  PubMed  CAS  Google Scholar 

  12. Fellahi JL, Magues JP, Marquer B, Guerot A, Mansat M, Cathala B (1995) Analgesia with intra-articular injection of buprenorphine after surgery of the shoulder. Cah Anesthesiol 43:313–318

    PubMed  CAS  Google Scholar 

  13. Flory N, Van-Gessel E, Donald F, Hoffmeyer P, Gamulin Z (1995) Does the addition of morphine to brachial plexus block improve analgesia after shoulder surgery? Br J Anaesth 75:23–26

    Article  PubMed  CAS  Google Scholar 

  14. Fujimara N, Namba H, Tsunoda K, Kawamata T, Taki K, Igarasi M, Namiki A (1995) Effect of hemidiaphragmatic paresis caused by interscalene brachial plexus block on breathing pattern, chest wall mechanics and arterial blood gases. Anesth Analg 81:962–966

    Google Scholar 

  15. Gentili ME, Lefoulon-Gourves M, Mamelle JC, Bonnet F (1994) Acute respiratory failure following interscalene block: complications of combined general and regional anesthesia. Reg Anesth 19:292–293

    PubMed  CAS  Google Scholar 

  16. Haasio J, Tuominen M, Rosenberg PH (1990) Continuous interscalene brachial plexus block during and after shoulder surgery. Ann Chir Gynaecol 79:103–107

    PubMed  CAS  Google Scholar 

  17. Hendolin H, Mattila MA (1988) Comparison of bupivaCaine hydrochloride 0.5% and bupivacaine carbonate 0.5% in interscalene plexus anesthesia. Reg Anaesth 11:12–15

    PubMed  CAS  Google Scholar 

  18. Hickey R, Blanchard J, Hoffman J, Sjovall J, Ramamurthy S (1990) Plasma concentrations of ropivacaine given with or without epinephrine for brachial plexus block. Can J Anaesth 37:878–882

    Article  PubMed  CAS  Google Scholar 

  19. Hickey R, Candido KD, Ramamurthy S, Winnie AP, Blanchard J, Raza SM, Hoffman J, Durrani Z, Masters RW (1990) Brachial plexus block with a new local anaesthetic: 0.5 per cent ropivacaine. Can J Anaesthesia 37:732–738

    Article  CAS  Google Scholar 

  20. Hickey R, Knape KG, Blanchard J, Hoffman J, Ramamurthy S (1990) Lidocaine hydrocarbonate is not superior to lidocaine hydrochloride in interscalene brachial plexus block. Reg Anesth 15:194–198

    PubMed  CAS  Google Scholar 

  21. Hickey R, Hoffman J, Ramamurthy S (1991) A comparison of ropivacaine 0.5% and bupivacaine 0.5% for brachial plexus block. Anesthesiology 74:639–642

    Article  PubMed  CAS  Google Scholar 

  22. Hickey R, Rowley CL, Candido KD, Hoffman J, Ramamurthy S, Winnie AP (1992) A comparative study of 0.25% ropivacaine and 0.25% bupivacaine for brachial plexus block. Anesth Analg 75:602–606

    Article  PubMed  CAS  Google Scholar 

  23. Hirasawa Y, Katsumi Y, Kusswetter W, Sprotte G (1990) Experimental studies on peripheral nerve injuries caused by injection needles. Reg Anaesth 13:11–5

    PubMed  CAS  Google Scholar 

  24. Huffnagle S, Seltzer JL, Torjman M, Marr A, Fenlin J (1993) Does the use of methylmethacrylate cement in total shoulder replacement induce haemodynamic or pulmonary instability? J Clin Anesth 5:404–407

    Article  PubMed  CAS  Google Scholar 

  25. Kumar A, Battit GE, Froese AB, Long MC (1971) Bilateral cervical and thoracic epidural blockade complicating interscalene brachial plexus block: report of two cases. Anesthesiology 35:650–652

    Article  PubMed  CAS  Google Scholar 

  26. Lucas MA, Harrop-Griffiths AW (1997) Interscalene patient-controlled analgesia. Anaesthesia 52:263–426

    Article  PubMed  CAS  Google Scholar 

  27. Mahoudeau G, Gaertner E, Launoy A, Ocquidant P, Loewenthal A (1995) Interscalene block: accidental catheterisation of the epidural space. Ann Fr Anesth Reanim 14:438–441

    PubMed  CAS  Google Scholar 

  28. Markham A, Faulds D, Ropivacaine (1996) A review of its pharmacology and therapeutic use in regional anaesthesia. Drugs 52:429–449

    Article  PubMed  CAS  Google Scholar 

  29. McCaughey W (1992) Adverse effects of local anaesthetics. Drug Safety 7:178–189

    Article  PubMed  CAS  Google Scholar 

  30. Mercadente S, Sapio M, Villari P (1995) Suprascapular nerve block by catheter for breakthrough shoulder cancer pain. Reg Anesth 20:343–346

    Google Scholar 

  31. Moore D, Mulroy M, Thompson G (1994) Peripheral nerve damage and regional anaesthesia. Br J Anaesthesia 73:435–436

    Article  CAS  Google Scholar 

  32. Nunn JF (1987) Applied respiratory physiology, 3rd edn. Butterworths, London

    Google Scholar 

  33. Parikh RK, Rymaszewski LR, Scott NB (1995) Prolonged postoperative analgesia for arthrolysis of the elbow joint. Br J Anaesth 74:469–471

    Article  PubMed  CAS  Google Scholar 

  34. Passannante AN (1996) Spinal anesthesia and permanent neurologic deficit after interscalene block. Anesth Ana1g 82:873–874

    CAS  Google Scholar 

  35. Patterson KW, Scanlon P (1990) An unusual complication of brachial plexus sheath cannulation. Br J Anaesth 65:542–543

    Article  PubMed  CAS  Google Scholar 

  36. Pere P (1993) The effect of continuous interscalene brachial plexus block with 0.125% bupivacaine plus fentanyl on diaphragmatic motility and ventilatory function. Reg Anesth 18:93–97

    PubMed  CAS  Google Scholar 

  37. Pere P, Tuominen M, Rosenberg PH (1991) Cumulation of bupivacaine, desbutylbupivacaine and 4-hydroxybupivaCaine during and after continuous interscalene brachial plexus block. Acta Anaesthesiol Scand 35:647–650

    Article  PubMed  CAS  Google Scholar 

  38. Pere P, Pitkanen M, Rosenberg PH, Bjorkenheim JM, Linden H, Salorinne Y, Tuominen M (1992) Effect of continuous interscalene brachial plexus block on diaphragm motion and on ventilatory function. Acta Anaesthesiol Scandi 36:53–57

    Article  CAS  Google Scholar 

  39. Pihlajamaki KK (1991) Inverse correlation between the peak venous serum concentration of bupivacaine and the weight of the patient during interscalene brachial plexus block. Br J Anaesth 67:621–622

    Article  PubMed  CAS  Google Scholar 

  40. Pihlajamaki KK, Lindberg RL (1987) Bupivacaine with and without adrenaline in interscalene brachial plexus blockade. Studies in patients with rheumatoid arthritis. Br J Anaesth 59:1420–1424

    Article  PubMed  CAS  Google Scholar 

  41. Ribeiro FC, Georgousis H, Bertram R, Scheiber G (1996) Plexus irritation caused by interscalene brachial plexus catheter for shoulder surgery. Anesth Analg 82:870–872

    PubMed  CAS  Google Scholar 

  42. Rice ASC (1996) Type of needle point and nerve damage. Anaesthesia 51:98–99

    Article  PubMed  CAS  Google Scholar 

  43. Rice ASC, McMahon SB (1992) Peripheral nerve injury caused by injection needles used in regional anaesthesia: the influence of bevel configuration, studied in a rat model. Br J Anaesth 69:433–438

    Article  PubMed  CAS  Google Scholar 

  44. Rice ASC, Andreev N, McMahon SB (1994) The consequences of microneurography electrode-induced injury of peripheral nerves observed in the rat and man. Pain 59:385–393

    Article  PubMed  CAS  Google Scholar 

  45. Roch JJ, Sharrock NE, Neudachin L (1992) Interscalene brachial plexus block for shoulder surgery: a proximal paresthesia is effective. Anesth Analg 75.386–388

    Article  PubMed  CAS  Google Scholar 

  46. Rosenberg PH, Pere P, Hekau R, Tuominen M (1991) Plasma concentrations of bupivacaine and two of its metabolites during continuous interscalene brachial plexus block. Br J Anaesth 66:25–30

    Article  PubMed  CAS  Google Scholar 

  47. Rosenberg PH, Lamberg TS, Tarkkila P, Marttila T, Bjorkenheim JM, Tuominen M (1995) Auditory disturbance associated with interscalene brachial plexus block. Br J Anaesth 74:89–91

    Article  PubMed  CAS  Google Scholar 

  48. Ross AF, Tinker JH (1994) Anesthesia risk. In: Miller RD (eds) Anesthesia. Churchill Livingstone, New York

    Google Scholar 

  49. Scammell SJ (1979) Case report: inadvertent epidural anaesthesia as a complication of interscalene brachial plexus block. Anaesth Intens Care 7:56–57

    CAS  Google Scholar 

  50. Selander D (1993) Peripheral nerve injury caused by injection needles. Br J Anaesth 71:323–324

    Article  PubMed  CAS  Google Scholar 

  51. Selander D, Dhuner K-G, Lundborg G (1977) Peripheral nerve injury due to injection needles used for regional anaesthesia. Acta Anaesthesiol Scand 21:182–188

    Article  PubMed  CAS  Google Scholar 

  52. Sharrock N (1991) Reg Anesth 15 [Suppl]:64

    Google Scholar 

  53. Sharrock NE, Savarese JJ (1994) Anesthesia for orthopaedic surgery. In: Miller RD (ed) Anesthesia. Churchill Livingstone, New York

    Google Scholar 

  54. Sukhani R, Winnie AP (1987) Clinical pharmacokinetics of carbonated local anesthetics. II. interscalene brachial block model. Anesth Analg 66:1245–1250

    PubMed  CAS  Google Scholar 

  55. Sukhani R, Winnie AP (1989) Clinical pharmacokinetics of carbonated local anesthetics. III interscalene brachial block model. Anesth Analg 68:90–93

    Article  PubMed  CAS  Google Scholar 

  56. Sukhani R, Barclay J, Aasen M (1994) Prolonged Horner’s syndrome after interscalene block: a management dilemma. Anesth Analg 79:601–603

    Article  PubMed  CAS  Google Scholar 

  57. Tetzlaff JE, Yoon HJ, Brems J (1994) Interscalene brachial plexus block for shoulder surgery. Reg Anesth 19:339–343

    PubMed  CAS  Google Scholar 

  58. Tetzlaff JE, Yoon HJ, Dilger J, Brems J (1994) Subdural anesthesia as a complication of an interscalene brachial plexus block. Case report. Reg Anesth 19:357–359

    PubMed  CAS  Google Scholar 

  59. Tetzlaff JE, Yoon HJ, Brems J, Javorsky T (1995) Alkalinization of mepivacaine improves the quality of motor block associated with interscalene brachial plexus anesthesia for shoulder surgery. Reg Anesth 20:128–132

    PubMed  CAS  Google Scholar 

  60. Thiagarajah S, Lear E, Azar I, Salzer J, Zeiligsohn E (1984) Bronchospasm following interscalene brachial plexus block. Anesthesiology 61:759–761

    Article  PubMed  CAS  Google Scholar 

  61. Thomson S (1990) Long-term indwelling catheter for intermittent axillary plexus blocks with bupivacaine. Anaesth Intens Care 18:276–277

    CAS  Google Scholar 

  62. Tuominen M, Pitkanen M, Rosenberg PH (1987) Postoperative pain relief and bupivacaine plasma levels during continuous interscalene brachial plexus block. Acta Anaesthesiol Scand 31:276–278

    Article  PubMed  CAS  Google Scholar 

  63. Tuominen M, Haasio J, Hekali R, Rosenberg PH (1989) Continuous interscalene brachial plexus block: clinical efficacy, technical problems and bupivacaine plasma concentrations. Acta Anaesthesiol Scand 33:84–88

    Article  PubMed  CAS  Google Scholar 

  64. Tuominen MK, Pere P, Rosenberg PH (1991) Unintentional arterial catheterization and bupivacaine toxicity associated with continuous interscalene brachial plexus block. Anesthesiology 75:356–358

    Article  PubMed  CAS  Google Scholar 

  65. Urmey WF, Gloeggler PJ (1993) Pulmonary function changes during interscalene brachial plexus block: effects of decreasing local anesthetic injection volume. Reg Anesth 18:244–2449

    PubMed  CAS  Google Scholar 

  66. Urmey WF, McDonald M (1992) Hemidiaphragmatic paresis during interscalene brachial plexus block: effects on pulmonary function and chest wall mechanics. Anesth Analg 74:352–357

    Article  PubMed  CAS  Google Scholar 

  67. Urmey WF, Talts KH, Sharrock NE (1991) One hundred per cent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg 72:498–503

    Article  PubMed  CAS  Google Scholar 

  68. Vainionpaa VA, Haavisto ET, Huha TM, Korpi KJ, Nuutinen LS, Hollmen AI, Jozwiak HM, Magnusson AA (1995) A clinical and pharmacokinetic comparison of ropivacaine and bupivacaine in axillary plexus block. Anesth Analg 81:534–538

    PubMed  CAS  Google Scholar 

  69. Wajima Z, Nakajima Y, Kim C, Kobayashi N, Kadotani H, Adachi H, Inoue T, Ogawa R (1995) IV compared with brachial plexus infusion of butorphanol for postoperative analgesia. Br J Anaesth 74:392–395

    Article  PubMed  CAS  Google Scholar 

  70. Wajima Z, Shitara T, Nakajima Y, Kim C, Kobayashi N, Kadotani H, Adachi H, Ishikawa G, Kaneko K, Inoue T (1995) Comparison of continuous brachial plexus infusion of butorphanol, mepivacaine and mepivacaine-butorphanol mixtures for postoperative analgesia. Br J Anaesth 75:548–551

    Article  PubMed  CAS  Google Scholar 

  71. Wildsmith JA, Tucker GT, Cooper S, Scott DB, Covino BG (1977) Plasma concentrations of local anaesthetics after interscalene brachial plexus block. Br J Anaesth 49:461–466

    Article  PubMed  CAS  Google Scholar 

  72. Winnie AP (1970) Interscalene brachial plexus block. Anesth Analg 49:455–66

    Article  PubMed  CAS  Google Scholar 

  73. Winnie AP (1983) Plexus anesthesia. Saunders, Philadelphia

    Google Scholar 

  74. Zablocki AD, Baysinger CL, Epps JL, Bucknell AL (1987) Cervical epidural anesthesia for surgery of the shoulder. Orthop Rev 16:98–10

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Harrop-Griffiths, W., Dwyer, S. (1999). Anaesthesia and Analgesia for Shoulder Arthroplasty. In: Walch, G., Boileau, P. (eds) Shoulder Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58365-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-58365-0_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63554-0

  • Online ISBN: 978-3-642-58365-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics