Dwyer Tim, Henry Patrick D G, Cholvisudhi Phantila, Chan Vincent W S, Theodoropoulos John S, Brull Richard
From the *University of Toronto Orthopedic Sports Medicine; †Division of Orthopedic Surgery, Department of Surgery, Women's College Hospital; ‡Mount Sinai Hospital; §University of Toronto; ∥Division of Orthopedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre; ¶Department of Anesthesia, Toronto Western Hospital, University Health Network; and #Women's College Hospital, Toronto, Ontario, Canada.
Reg Anesth Pain Med. 2015 Sep-Oct;40(5):431-42. doi: 10.1097/AAP.0000000000000178.
Many anesthesiologists are unfamiliar with the rate of surgical neurological complications of the shoulder and elbow procedures for which they provide local anesthetic-based anesthesia and/or analgesia. Part 1 of this narrative review series on neurological complications of elective orthopedic surgery describes the mechanisms and likelihood of peripheral nerve injury associated with some of the most common shoulder and elbow procedures, including open and arthroscopic shoulder procedures, elbow arthroscopy, and total shoulder and elbow replacement. Despite the many articles available, the overall number of studied patients is relatively low. Large prospective trials are required to establish the true incidence of neurological complications following elective shoulder and elbow surgery.
WHAT'S NEW: As the popularity of regional anesthesia increases with the development of ultrasound guidance, anesthesiologists should have a thoughtful understanding of the nerves at risk of surgical injury during elective shoulder and elbow procedures.
许多麻醉医生并不熟悉他们为之提供局部麻醉和/或镇痛的肩部和肘部手术的神经并发症发生率。这个关于择期骨科手术神经并发症的叙述性综述系列的第1部分描述了与一些最常见的肩部和肘部手术相关的周围神经损伤的机制和可能性，包括开放性和关节镜下肩部手术、肘关节镜检查以及全肩关节和肘关节置换术。尽管有许多相关文章，但研究患者的总数相对较少。需要进行大型前瞻性试验来确定择期肩部和肘部手术后神经并发症的真实发生率。
随着超声引导下区域麻醉的普及，麻醉医生应该深入了解择期肩部和肘部手术期间有手术损伤风险的神经。
