Arthroscopic subacromial decompression performed under local anesthesia.
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.
Karkabi
Suhail
S
Unit of Arthroscopic Surgery, Rambam Medical Center, Haifa, Israel. v_s_karkabi@hotmail.com
Besser
Michael
M
Zinman
Chaim
C
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
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D008874:Midazolam; D005283:Fentanyl; D004837:Epinephrine