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https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#1
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29102011/editorial-commentary-my-shoulder-feels-great-but-why-is-my-thigh-numb-lateral-femoral-cutaneous-nerve-injury-after-shoulder-arthroscopy-in-the-beach-chair-position
#2
EDITORIAL
Michael D Feldman
Lateral femoral cutaneous nerve injury after shoulder arthroscopy in the beach chair position is an uncommon, but irritating complication for patients. Taking an extra minute to ensure a safe beach chair position will likely minimize the occurrence and prevent a disheartening conversation at the first postoperative visit.
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29063680/development-of-a-physical-shoulder-simulator-for-the-training-of-basic-arthroscopic-skills
#3
Laura C McCracken, Ana Luisa Trejos, Marie-Eve LeBel, Behnaz Poursartip, Abelardo Escoto, Rajni V Patel, Michael D Naish
BACKGROUND: Orthopaedic training programs are incorporating arthroscopic simulations into their residency curricula. There is a need for a physical shoulder simulator that accommodates lateral decubitus and beach chair positions, has realistic anatomy, allows for an objective measure of performance and provides feedback to trainees. METHODS: A physical shoulder simulator was developed for training basic arthroscopic skills. Sensors were embedded in the simulator to provide a means to assess performance...
October 23, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29058613/effect-of-interscalene-block-on-intraocular-pressure-and-ocular-perfusion-pressure
#4
Betul Basaran, Aysun Ankay Yilbas, Zeki Gultekin
BACKGROUND: Interscalene block (ISB) is commonly associated with Horner's syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). The aim of the study was to investigate whether ISB affects IOP and/or OPP. METHODS: Thirty patients scheduled for ambulatory shoulder surgery under regional anesthesia with a single-shot ISB (15 mL 0...
October 23, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28969950/prevalence-and-risk-factors-for-lateral-femoral-cutaneous-nerve-palsy-in-the-beach-chair-position
#5
Ari J Holtzman, Christopher D Glezos, Eric J Feit, Konrad I Gruson
PURPOSE: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development. METHODS: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28846536/effect-of-blood-pressure-elevation-on-cerebral-oxygen-desaturation-in-the-beach-chair-position
#6
Keishu Hayashi, Kumiko Tanabe, Kimito Minami, Koji Sakata, Kiyoshi Nagase, Hiroki Iida
OBJECTIVE: The beach chair position (BCP) during shoulder arthroscopy is a known risk factor for cerebral ischemia. We retrospectively investigated whether maintaining the arterial blood pressure (ABP) prevented the decrease in the regional cerebral tissue oxygen saturation (rSO2). METHODS: We analyzed 20 consecutive patients who underwent elective shoulder surgery in the BCP under general anesthesia. The bilateral rSO2 was monitored continuously throughout the procedure with the help of near-infrared spectroscopy (INVOS 5100 Cerebral Oximeter, Somanetics Corporation, Troy, MI, USA)...
March 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28790863/great-auricular-neuropraxia-with-beach-chair-position
#7
Minal Joshi, Ruth Cheng, Hattiyangadi Kamath, Joel Yarmush
Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28776638/a-novel-combination-of-peripheral-nerve-blocks-for-arthroscopic-shoulder-surgery
#8
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
October 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28741323/-osteosynthesis-with-locking-plate-and-minimally-invasive-technique-for-proximal-humeral-fractures
#9
C Arroyo-Sánchez, C Abril-Gaona, D Rincón-Cardozo
OBJECTIVE: To report our experience in the treatment of 2-3 fragment proximal humeral fractures using a minimally invasive technique that involves an angular-stable locking implant and find out the factors affecting patients outcomes. MATERIAL AND METHODS: Descriptive, prospective study of the case series type. Twenty-two patients, 13 females and 9 males, were operated on between February 2010 and August 2012. Mean age was 50.8 years (24-82 years). Patients were placed in a beach-chair position...
January 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28669598/how-satisfied-are-patients-with-arthroscopic-bankart-repair-a-2-year-follow-up-on-quality-of-life-outcome
#10
Tim Saier, Johannes E Plath, Sabrina Waibel, Philipp Minzlaff, Matthias J Feucht, Peter Herschbach, Andreas B Imhoff, Sepp Braun
PURPOSE: To report general life and health satisfaction after arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability and to investigate postoperative time lost to return to work at 2-year follow-up. METHODS: Between 2011 and 2013 patients treated with arthroscopic Bankart repair in the beach chair position for acute shoulder instability were included in this study. Questions on Life Satisfaction Modules (FLZ(M)) and the Short Form 12 (SF-12) were used as quality-of-life outcome scales...
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28558702/background-anaesthetic-agents-do-not-influence-the-impact-of-arginine-vasopressin-on-haemodynamic-states-and-cerebral-oxygenation-during-shoulder-surgery-in-the-beach-chair-position-a-prospective-single-blind-study
#11
RANDOMIZED CONTROLLED TRIAL
Eun-A Jang, Ji-A Song, Ji Youn Shin, Jae Joon Yoon, Kyung Yeon Yoo, Seongtae Jeong
BACKGROUND: Administration of arginine vasopressin (AVP) is associated with reducing jugular venous (SjvO2) and regional cerebral (rScO2) oxygen saturation under propofol-remifentanil (P/R) anaesthesia. We determined whether background anaesthetics modulate the effect of AVP on cerebral oxygenation and haemodynamics. METHODS: We randomly allocated 60 adult patients scheduled for shoulder surgery in the beach chair position (BCP) into 4 groups, to receive either an intravenous bolus of saline (groups PR-S and SN-S) or 0...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28478900/the-effect-of-the-beach-chair-position-angle-on-cerebral-oxygenation-during-shoulder-surgery
#12
Chad E Songy, Eric R Siegel, Mark Stevens, John T Wilkinson, Shahryar Ahmadi
BACKGROUND: Although the safety of the beach-chair position (BCP) is widely accepted, rare devastating neurologic complications have been reported and attributed to cerebral hypoperfusion. Cerebral oxygenation (regional oxygen saturation [rSO2]) can be monitored noninvasively using near-infrared spectroscopy. The purpose of this study was to determine the effect of BCP angle on cerebral oxygenation in patients undergoing shoulder surgery in the BCP. METHODS: Fifty patients undergoing shoulder arthroscopy were prospectively enrolled to participate...
September 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28367287/effect-of-an-epinephrine-mixture-for-interscalene-block-on-hemodynamic-changes-after-the-beach-chair-position-under-general-anesthesia-a-retrospective-study
#13
Bum-June Kim, Chae-Seong Lim, Boo-Hwi Hong, Ji-Yong Lee, Sun-Yeul Lee, Jung-Un Lee, Yoon-Hee Kim, Won-Hyung Lee, Seok-Hwa Yoon
BACKGROUND: The beach chair position (BCP) can cause significant hypotension. Epinephrine is used to prolong the duration of local anesthetics; it is also absorbed into blood and can exert systemic effects. This study determined the effects of epinephrine mixed with ropivacaine for an interscalene block (ISB) on hemodynamic changes related to BCP. METHODS: Patient data collected from March 2013 to August 2014 were used retrospectively. We divided the patients into three groups: 1) ISB only, 2) I+G (general anesthesia after ISB without epinephrine), and 3) I+E+G (general anesthesia after ISB with epinephrine)...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28255948/what-adverse-events-and-injuries-are-cited-in-anesthesia-malpractice-claims-for-nonspine-orthopaedic-surgery
#14
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
December 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28224065/the-supine-position-for-shoulder-arthroscopy
#15
Chonlathan Iamsumang, Bancha Chernchujit
Shoulder arthroscopy is traditionally performed with the patient in either the beach chair position or the lateral decubitus position. Each position has its advantages and disadvantages. The main topics for consideration include ease of surgery, view into the surgical field, risks to the patient, and economics of the setup. In the lateral decubitus position, it is inconvenient to work through the anterior portal and it is difficult to convert to an open procedure. In the beach chair position, it is difficult to manage the airway and cerebral oxygenation and the patient's head and the beach chair frame obstruct the insertion of a scope into the superior and posterior portals...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28101589/-intramedullary-nailing-in-diaphyseal-clavicle-fractures-using-minimally-invasive-percutaneous-reduction
#16
REVIEW
M Müller, T Freude, U Stöckle, T M Kraus
OBJECTIVE: Closed reduction and intramedullary nailing is common in diaphyseal clavicle fractures. The aim of this report is to demonstrate a surgical method with minimally invasive percutaneous reduction in cases where closed reduction fails. The procedure is associated with good cosmetic results. INDICATIONS: Percutaneous reduction using two reduction forceps enables intramedullary nailing without an open procedure. CONTRAINDICATIONS: Open, multifragmented or non-dislocated fractures, oblique fractures due to postoperative dislocation or shortening risk, fracture having potential to become compound fractures, neurovascular complications, pseudoarthroses...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27909677/basic-shoulder-arthroscopy-lateral-decubitus-patient-positioning
#17
Alexander H Jinnah, Sandeep Mannava, Johannes F Plate, Austin V Stone, Michael T Freehill
Shoulder arthroscopy offers a minimally invasive surgical approach to treat a variety of shoulder pathologies. The patient can be positioned in either the lateral decubitus or the beach chair position. This note and accompanying video describe the operating room setup for shoulder arthroscopy in the lateral decubitus position, including positioning of the arms, head, and sterile preparation and draping. Appropriate lateral decubitus positioning for shoulder arthroscopy with careful attention to detail will promote ease of surgical intervention and minimize complications...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909672/arthroscopic-360%C3%A2-capsular-release-for-adhesive-capsulitis-in-the-lateral-decubitus-position
#18
Gregory L Cvetanovich, Timothy Leroux, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904212/functional-outcome-after-primary-hemiarthroplasty-in-three-or-four-part-proximal-humerus-fracture-a-short-term-followup
#19
Saurabh Agarwal, Ashish Rana, Rajeev K Sharma
BACKGROUND: Several modalities of treatment are being used for the management of proximal humerus fractures. Primary hemiarthroplasty in proximal humerus fracture is indicated in three or four part fracture or fracture dislocations. It is also indicated if fracture involves a large area of articular cartilage loss and viability of head is doubtful. We studied the functional outcome of hemiarthroplasty in comminuted proximal humerus fracture. MATERIALS AND METHODS: 29 patients of three or four part proximal humerus fractures, (according to Neer's classification) who underwent primary shoulder hemiarthroplasty were included in this retrospective study...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27871574/cerebral-oxygenation-in-the-beach-chair-position-for-shoulder-surgery-in-regional-anesthesia-impact-on-cerebral-blood-flow-and-neurobehavioral-outcome
#20
José A Aguirre, Olivia Märzendorfer, Muriel Brada, Andrea Saporito, Alain Borgeat, Philipp Bühler
STUDY OBJECTIVE: Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. DESIGN: This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. SETTING: University hospital operating room...
December 2016: Journal of Clinical Anesthesia
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