“What type of anesthesia is used for rotator cuff surgery?”
I will have rotator cuff surgery next month. What type of anesthesia is used for rotator cuff surgery?
2 Answers
Rotator cuff surgery requires a general anesthetic. A regional block, such as an interscalene block, can reduce pain after surgery.
Repair of the rotator cuff may be performed by an orthopedic surgeon either arthroscopically (usually 3-4 small incisions using a small arthroscope and a camera/viewing screen system) or open (single longer incision). Likewise, the anesthetic for the procedure may be either general anesthesia (drug induced loss-of-consciousness) or regional blockade anesthesia (local anesthetics used to block the major nerves which supply sensation to the shoulder joint and upper extremity); the latter technique may or may not be accompanied by varying levels of sedation. To complicate matters more, the position of the patient during the surgery may be either sitting (commonly called "beach chair") or lateral (the non-surgical side of the patient lays on the operating bed and the surgical shoulder is placed upward, often with the surgical extremity angled towards the ceiling of the operating room.
Regardless of the surgical technique, the most common anesthetic approach is a combination of general anesthesia using an airway device (placed after the patient is unconscious to safely deliver oxygen) AND a regional block of some kind to address the significant postoperative pain involved with major shoulder surgery. The most common shoulder surgery block is an interscalene block performed using ultrasound guidance to visualize the nerve network, blood vessels, lung cavity, and other anatomical structures in the neck/shoulder area. The block is usually performed preoperatively so that when the patient wakes up from general anesthesia, he or she is comfortable.
Orthopedic surgeons often have a preference regarding anesthetic technique and surgical position; you should discuss with your orthopedic surgeon for more information.
Both general anesthesia and regional blocks carry risks and benefits. Common risks of general anesthesia in healthy patients include sore throat (from airway device), nausea, and hypotension; uncommon risks of general anesthesia include breathing problems, heart problems, and other problems. Common risks of interscalene blocks (and similar shoulder blocks) are patchy block (incomplete pain relief), nerve paresthesia ("twinge" when the injection needle travels near a nerve); uncommon risks of interscalene block include blood vessel injury, breathing problems (due to effect of local anesthetics on the nerve supply to the diaphragm [the diaphragm is your main muscle of breathing]), and injury to the lung cavity.
Problems with general and regional anesthesia are more common in patients with pre-existing health problems, including obesity, diabetes, asthma, and COPD. You should consult an anesthesiologist preoperatively for a thorough discussion of risks and benefits based on your individual health history.
Regardless of the surgical technique, the most common anesthetic approach is a combination of general anesthesia using an airway device (placed after the patient is unconscious to safely deliver oxygen) AND a regional block of some kind to address the significant postoperative pain involved with major shoulder surgery. The most common shoulder surgery block is an interscalene block performed using ultrasound guidance to visualize the nerve network, blood vessels, lung cavity, and other anatomical structures in the neck/shoulder area. The block is usually performed preoperatively so that when the patient wakes up from general anesthesia, he or she is comfortable.
Orthopedic surgeons often have a preference regarding anesthetic technique and surgical position; you should discuss with your orthopedic surgeon for more information.
Both general anesthesia and regional blocks carry risks and benefits. Common risks of general anesthesia in healthy patients include sore throat (from airway device), nausea, and hypotension; uncommon risks of general anesthesia include breathing problems, heart problems, and other problems. Common risks of interscalene blocks (and similar shoulder blocks) are patchy block (incomplete pain relief), nerve paresthesia ("twinge" when the injection needle travels near a nerve); uncommon risks of interscalene block include blood vessel injury, breathing problems (due to effect of local anesthetics on the nerve supply to the diaphragm [the diaphragm is your main muscle of breathing]), and injury to the lung cavity.
Problems with general and regional anesthesia are more common in patients with pre-existing health problems, including obesity, diabetes, asthma, and COPD. You should consult an anesthesiologist preoperatively for a thorough discussion of risks and benefits based on your individual health history.
