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
