Shoulder Surgeries under Regional Anesthesia Approach and Outcome - A Case Series

Shoulder surgeries (arthroscopic or open) are usually performed under general anesthesia or combined with regional anesthesia. Post-operative pain following shoulder surgery is usually very severe and hinders early mobility of joints and recovery; which is also a cause of mental stress for the patient. Regional anesthetic techniques are known to provide excellent pain control postoperatively, both at rest and on movement. It allows faster recovery with earlier mobilization of joints. Profound knowledge of neural innervation of the shoulder is very essential to provide successful regional anesthesia for shoulder surgeries.

We underwent a case series of 10 patients with multiple comorbidities and were categorized as high-risk patients, posted for shoulder surgeries under regional anesthesia (PNS-guided interscalene brachial plexus block combined with suprascapular nerve block). Five out of ten patients were of the ASA 3 category, with multiple comorbidities. Shoulder surgeries (arthroscopic/open) were planned under regional anesthesia with mild sedation and resulted in better surgeon and patient satisfaction perioperatively.

Interscalene nerve block combined with suprascapular nerve block should be considered an alternative approach to general anesthesia for shoulder surgeries. Thus sole regional anesthesia can be considered a novel approach for all types of shoulder surgeries and is significantly safer for ASA Grade III and IV patients.