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Related Experiment Video

Updated: Mar 23, 2026

Reverse Total Shoulder Arthroplasty

Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

Severe refractory hypertension during shoulder arthroscopy.

R O Abrons¹, S E Ellis¹

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.

Keywords:

Epinephrine-containing irrigant inadvertant epinephrine administration refractory hypertension shoulder arthroscopy

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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.