Thursday, December 15, 2011

Anesthesia for shoulder surgery, interscalene brachial plexus block vs. general anesthesia

In most cases, we prefer general anesthesia over brachial plexus block anesthesia for our shoulder arthroplasty and rotator cuff procedures.

The reasons for our recommendation are several:
General anesthesia allows us to monitor nerve function during and after the case - this is important with major shoulder reconstruction.
General anesthesia does not produce a transient paralysis of the diaphragm on the side of surgery.
General anesthesia wears off while the patient is in the recovery room when the high level of nursing is immediately available in contrast to blocks which wear off in the early hours of the morning when nurses are less available.
While the complication rate of either method is low, the complications of brachial plexus block anesthesia include the possibility of long lasting or permanent nerve injury.
We do consider brachial plexus anesthesia when there are special circumstances, such as opiod intolerance or strong patient preference.

Those considering brachial plexus block anesthesia may wish to check out the following link (Complications).

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