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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Severe refractory hypertension during shoulder arthroscopy
1Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Saudi Journal of Anaesthesia
|April 7, 2016
Summary
Epinephrine-containing saline used in shoulder arthroscopy may cause severe cardiovascular issues, contrary to previous beliefs. This case highlights potential risks associated with this common surgical practice.
Area of Science:
- Orthopedic Surgery
- Cardiovascular Physiology
- Anesthesiology
Background:
- Epinephrine-containing saline irrigants are popular in arthroscopic shoulder surgery for improved visualization and reduced bleeding.
- Previous reports suggested no significant adverse cardiovascular effects from intra-articular epinephrine use.
Observation:
- A patient undergoing shoulder arthroscopy received a standard intra-articular infusion of epinephrine-containing normal saline (1 mcg/mL).
- The patient experienced severe hemodynamic consequences following the infusion.
Findings:
- Intra-articular epinephrine administration can lead to significant and severe cardiovascular complications.
- The assumption of cardiovascular safety for epinephrine irrigating solutions in arthroscopic surgery may be inaccurate.
Implications:
- Clinicians should exercise caution when using epinephrine-containing solutions for arthroscopic shoulder surgery.
- Further research is needed to evaluate the true cardiovascular risks and establish safer protocols.
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