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Minerva Anestesiologica 2022 July-August;88(7-8):629-34

DOI: 10.23736/S0375-9393.22.16295-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Regional anesthesia for shoulder surgery

Peter MARHOFER ^{1, 2} ✉, Arpad HARKANYI ¹, Phil M. HOPKINS ³

¹ Department of Anesthesiology and Intensive Care Medicine, Orthopedic Hospital Speising, Vienna, Austria; ² Department of Anesthesiology, General Intensive Care Medicine and Pain Therapy, Medical University of Vienna, Vienna, Austria; ³ Institute of Medical Research at St. James’s, University of Leeds, Leeds, UK

Regional anesthesia should be the preferred technique for analgesia in shoulder surgery, which is a frequent procedure in the daily practice of anesthesiologists. The use of ultrasound guidance enables the visualization of the relevant nerve structures and the adjacent anatomical details. Low volumes of local anesthetics reduce the incidence of inadvertent blockade of the phrenic nerve with subsequent respiratory impairment. The additional administration of dexmedetomidine to local anesthetics prolonges the duration of analgesia with a minimal increased incidence of haemodynamic side effects. An optimal workflow is associated with economical advantages due to an improved use of operation rooms. Attention have to be paid regarding intraoperative hypotension, cerebral hypoperfusion and complications due to positioning.

KEY WORDS: Shoulder joint; Brachial plexus block; Cervical plexus block; Ultrasonography; Hypotension