title: Indwelling interscalene catheter use in an outpatient setting for shoulder surgery: technique, efficacy, and complications.
abstract: Indwelling interscalene catheters are utilized for inpatient postoperative pain control after shoulder surgery. Improved medical equipment and advanced techniques may allow safe and efficacious outpatient use. One hundred and forty-four consecutive indwelling interscalene catheter placements were reviewed to determine adverse events, complications, and efficacy. Real-time ultrasound-guided catheter placement technique is described. Post-anesthesia care unit (PACU) narcotic consumption and last recorded pain score were reviewed to gauge efficacy. The catheter placement technique was 98% successful. There were 14 (9.7%) minor adverse events including inadequate analgesia (8), accidental catheter removal (4) of disconnection (1), and shortness of breath (1). The single complication (0.7%) was a small apical pneumothorax. The average PACU narcotic consumption in intravenous morphine equivalents was 1.7 mg. The average last recorded PACU pain score on a scale of 1 to 10 was 0.6. Catheter placement under real-time ultrasound guidance is accurate. Outpatient use of indwelling interscalene catheters is safe and efficacious.
authors.affiliation: Department of Orthopedics, University of Utah, Salt Lake City, UT 84108, USA. nab1970@hotmail.com
authors.forename: Nathaniel A
authors.initials: NA
authors.lastname: Bryan
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Swenson
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Greis
authors.forename: Robert T
authors.initials: RT
authors.lastname: Burks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001182:Arthroscopy; D001917:Brachial Plexus; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy; D012785:Shoulder Joint
chemical_list: D000701:Analgesics, Opioid