Anesthesia for local shoulder operations

DR. YVES DEPAEPE

LOCAL ANESTHESIA for shoulder operations or INTERSCALEN BLOCK

Certain shoulder operations are associated with postoperative pain. This pain can be well controlled by numbing the nerves of the shoulder and arm. Numbing these nerves becomes a interscalene block called and is done by means of a puncture in the neck region door de anesthesist vooraleer u onder narcose gaat. Dit interscaleen blok wordt uitgevoerd met behulp van echografie en/of zenuwstimulatie (uw spieren laten bewegen dmv kleine elektrische stroompjes). De arm wordt zwaar en gevoelloos wanneer de verdoving begint te werken, en dit duurt gemiddeld 10 uur. Na het plaatsen van dit blok zal de anesthesist starten met de algemene verdoving.

Advantages of interscalene block

• Good pain relief for the operated shoulder and a comfortable recovery.
• Less need for strong painkillers and therefore fewer side effects during your hospital stay.
• Less heavy general anesthesia so you wake up faster.
• Less risk of nausea and vomiting after anesthesia.
• Less pain during rehabilitation.
• Easier surgical accessibility due to relaxed shoulder muscles.

Possible complications (list is not exhaustive)

• Temporary hoarseness and a drooping eyelid as the nerves of your eye and vocal cord are close by and are sometimes slightly anesthetized. This disappears together with the anesthesia.
• Slight feeling of shortness of breath if the diaphragm is also anesthetized, especially in patients who already have airway problems. A low dose of oxygen is then given for this. The complaints also disappear when the anesthesia wears off.
• Extremely rarely, the nerve can be hit. In most cases, the nerve recovers over a longer period of time, up to 6 weeks after the operation.
• In rare cases, puncturing the lung tip can cause a small collapsed lung, resulting in shortness of breath. This usually heals spontaneously, but an admission for observation is necessary.
• Allergic reaction to the anesthetic or toxic reaction due to injection into the bloodstream.
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