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Arthroscopic subacromial decompression performed under local anesthesia.
Suhail Karkabi1, Michael Besser, Chaim Zinman
1Unit of Arthroscopic Surgery, Rambam Medical Center, Haifa, Israel. v_s_karkabi@hotmail.com
Summary
Shoulder arthroscopy and decompression can be safely performed using local anesthesia and sedation in high-risk patients. This approach offers a viable alternative when general anesthesia or interscalene blocks are not suitable.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
Background:
- Shoulder arthroscopy typically uses general anesthesia or interscalene blocks.
- These anesthesia methods can have contraindications or failure rates.
- High-risk patients require alternative anesthetic techniques for shoulder procedures.
Purpose of the Study:
- To evaluate the feasibility and patient satisfaction of performing shoulder arthroscopy and decompression under local anesthesia in high-risk patients.
- To assess the efficacy of local anesthesia combined with sedation for shoulder surgery.
Main Methods:
- Eight high-risk patients underwent shoulder arthroscopy and decompression in the beach-chair position.
- Local anesthesia involved 50 mL of 1% lidocaine infiltrated into the joint, surrounding tissues, and subacromial space.
- Intravenous midazolam and fentanyl were administered for sedation prior to local anesthetic infiltration.
Main Results:
- All 8 patients tolerated the procedure well under local anesthesia and sedation.
- Patient satisfaction with the provided analgesia was high.
- The study demonstrated successful execution of shoulder arthroscopy and decompression using this technique.
Conclusions:
- Shoulder arthroscopy and subacromial decompression can be effectively performed under local anesthesia combined with sedation.
- This method provides a safe and satisfactory anesthetic option for high-risk surgical candidates.
- Local anesthesia offers a potential alternative for shoulder procedures when other methods are contraindicated.