2017 ISAKOS Biennial Congress ePoster #2232

 

Postoperative AnalgesiafFor Arthroscopic Rotator Cuff Suture with Continuous Sub Acromial Infusion of Local Anesthetic

Alexandre De Almeida, MD, Caxias do Sul, RS BRAZIL
Márcio Rangel Valin, MD, Caxias Do Sul, RS BRAZIL
Vinícius Bachinski, resident, Caxias Do Sul, RS BRAZIL
Nayvaldo Couto Almeida, MD, Caxias Do Sul, RS BRAZIL
Ana Paula Agostini, MD, Caxias Do Sul, RS BRAZIL

Hospital Saude and Hospital Pompeia, Caxias do Sul, RS, BRAZIL

FDA Status Not Applicable

Summary

Its important to know a “Plan B” regarding the control of the postoperative pain. The use for a cateter to control the pain in selected patients cam be efficiently and at low risk when the interscalenic blocked is difficult or contra-indicated.

Abstract

The postoperative of shoulder arthroscopy may in some cases be considered painful. It’s necessary to use efficiently and at low risk analgesia with less collateral effects. Certain features such as personal biotype and obesity can be associated with a higher failure rate of interscalenic blocked and set these patients outside of the possibility of using this excellent method to control post-operative pain. We believe that these patients may benefit from the use of alternative postoperative analgesia in continuous infusion of local anesthetics through an epidural catheter placed into the sub acromial space at the end of the surgery. Methods: Between April 2006 and March 2013, 579 patients underwent shoulder arthroscopy for the treatment of sub acromial pathology and used continuous infusion of Ropivacaine into the sub acromial space through a pump. After undergoing the exclusion criteria (revision surgeries and insufficient records), remaining 554 patients. Results: The mean age of the sample was 54.6 years. 347 (62.6%) were females and 207 were males. There were 403 (72.7%) dominant arms. 27 patients (4.87%) had complications directly related to the analgesia method. The three complications directly related to the analgesia method were: 16 cases of inadequate analgesia (2.88%), 10 cases of accidental catheter removal (1.8%) and 1 case of seizure (0.18%). The frequency of insufficient analgesia was not higher in large and extensive lesions compared to small and medium-sized rotator cuff lesions (p=0.234). Nor was higher in patients who underwent Mumford Procedure or Internal capsulotomy to achieve closure of the cuff lesion. Conclusion: The continuous infusion of local anesthetic through an epidural catheter placed in the sub acromial space is effective and has few complications in controlling postoperative pain after shoulder arthroscopy.