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Minerva Anestesiologica 2006 December;72(12):995-1000

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English, Italian

Airway obstruction during arthroscopic shoulder surgery: anesthesia for the patient or for the surgeon?

Antonucci S. ¹, Orlandi P. ¹, Mattei P. A. ², Amato F. ¹

¹ Department of Anesthesia and Intensive Care Medicine SS. Trinità Hospital, Popoli (PE), Italy 2 Department of Biomedical Sciences Faculty of Medicine and Surgery G. D’Annunzio University, Chieti, Italy

Two cases of airway obstruction as a result of oedema of laryngeal structures which arose during protracted arthroscopic shoulder surgery, in which single-shot interscalene blocks had been performed, are reported. In these 2 cases, the complexity of the pathologies and the fact that the surgeons were at the beginning of their surgical experience are the most likely causes of the conditions which led to tracheal compression from extra-articular leakage of fluid. Therefore, we recommend a combined peripheral block and general anaesthesia with tracheal intubation for procedures performed by surgeons without an adequate experience and on obese patients, patients placed in a lateral decubitus, or procedures in which difficulties are expected. The advantages of regional anaesthesia with a constant control of the airways are underlined.