title: Arthroscopic subacromial decompression performed under local anesthesia.
abstract: Shoulder arthroscopy is usually performed under general anesthesia or interscalene block. General anesthesia may be contraindicated and interscalene block sometimes fails. We had 8 patients who were at high-risk and, therefore, shoulder arthroscopy and decompression were performed under local anesthesia in the beach-chair position. We used 50 mL of 1% lidocaine; 30 mL were infiltrated into the skin and underlying tissues and into the glenohumeral joint, and the rest was infiltrated into the subacromial joint. Before the infiltration, all patients were given 5 mg midazolam and 0.1 mg fentanyl intravenously. All 8 patients were satisfied with the analgesia provided by the anesthesia. We conclude that arthroscopy and subacromial decompression can be readily performed under local anesthesia in combination with efficient sedation.
authors.affiliation: Unit of Arthroscopic Surgery, Rambam Medical Center, Haifa, Israel. v_s_karkabi@hotmail.com
authors.forename: Suhail
authors.initials: S
authors.lastname: Karkabi
authors.forename: Michael
authors.initials: M
authors.lastname: Besser
authors.forename: Chaim
authors.initials: C
authors.lastname: Zinman
mesh_terms: D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy / Q000379:methods*; D016292:Procedural Sedation; D019299:Decompression, Surgical / Q000379:methods*; D004837:Epinephrine / Q000008:administration & dosage; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007270:Injections, Intra-Articular; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D011292:Premedication; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D008874:Midazolam; D005283:Fentanyl; D004837:Epinephrine