Shoulder arthroscopy is used to treat various diseases of the shoulder, including refractory adhesive capsulitis, chronic tendonitis, partial tears of the long biceps tendon, superior labrum anterior-posterior (SLAP) lesions, and shoulder instability. Even minor shoulder surgery, such as rotator cuff repair, may lead to severe postoperative pain within the first 48-72 hours. This not only causes discomfort for the patient, but also compromises the intensive postoperative physiotherapy that is essential to avoid recurrence of the problem. Effective postoperative pain relief is critical for these patients, as the success of surgery largely depends on early and regular physiotherapy. Although traditionally, various methods of postoperative analgesia have been described, each has its own disadvantages. A case of adhesive capsulitis was reported, for which arthroscopic capsular release was carried out under cervical epidural anesthesia with general anesthesia, resulting in excellent intraoperative and postoperative analgesia, with a better patient compliance for physiotherapy, and a significant improvement in the range of movement at the shoulder joint. Arthroscopic surgery, being a minimally invasive surgery, reduces recovery time, and may increase the rate of surgical success due to less trauma to the connective tissue. It is concluded that cervical epidural anesthesia, together with general anesthesia, can be a safe and effective method of conducting shoulder arthroscopic surgery, and providing analgesia for postoperative physiotherapy. However, it should be performed by an experienced anesthesiologist and careful monitoring of the patient should continue in the intraoperative and postoperative period, bearing in mind the abovementioned complications.
Author
(s) Details
Ketaki
Marodkar
Department of Anaesthesiology, NKP Salve Institute of Medical
Sciences and Research Centre, Nagpur, Maharashtra, India.
Please see the book here:- https://doi.org/10.9734/bpi/msti/v12/4994
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