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优化门诊肩部手术：麻醉选择综述

Optimizing Outpatient Shoulder Surgery: A Review of Anesthetic Options.

作者信息

Fisher Brandon, Martusiewicz Alexander, Wiater Brett, Wiater J Michael

机构信息

From the Department of Orthopaedic Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, MI.

出版信息

J Am Acad Orthop Surg. 2025 Jan 1;33(1):e1-e10. doi: 10.5435/JAAOS-D-24-00156. Epub 2024 Aug 16.

DOI:10.5435/JAAOS-D-24-00156
PMID:39163634
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11630655/
Abstract

With the recent trends toward outpatient shoulder surgery, standardized protocols for perioperative analgesia are critical for reducing length of stay and optimizing outcomes. There are a variety of described anesthetic and analgesic options for shoulder surgery, and the literature is variable regarding optimal choice as patient, provider, and institutional factors often play a role. With general anesthesia alone becoming less utilized, regional methods require critical examination. Knowledge of the differing, and novel, regional anesthetic procedures in conjunction with recent orthopaedic and anesthetic literature is imperative to providing patients with optimal and efficient care.

摘要

随着近期门诊肩部手术的趋势，围手术期镇痛的标准化方案对于缩短住院时间和优化治疗效果至关重要。肩部手术有多种已描述的麻醉和镇痛选择，由于患者、医疗服务提供者和机构因素往往起作用，关于最佳选择的文献存在差异。随着单纯全身麻醉的使用越来越少，区域麻醉方法需要进行严格审查。了解不同的新型区域麻醉程序以及近期的骨科和麻醉文献对于为患者提供最佳和高效的护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/585764251b87/jaaos-33-e1-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/266c00345a2e/jaaos-33-e1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/47eca9a3f40e/jaaos-33-e1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/afe7d292d1ab/jaaos-33-e1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/3dcd80116435/jaaos-33-e1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/585764251b87/jaaos-33-e1-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/266c00345a2e/jaaos-33-e1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/47eca9a3f40e/jaaos-33-e1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/afe7d292d1ab/jaaos-33-e1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/3dcd80116435/jaaos-33-e1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2622/11630655/585764251b87/jaaos-33-e1-g005.jpg

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本文引用的文献

1
Complication rates and efficacy of single-injection vs. continuous interscalene nerve block: a prospective evaluation following arthroscopic primary rotator cuff repair without a concomitant open procedure.单次注射与连续肌间沟神经阻滞的并发症发生率及疗效：对无同期开放手术的关节镜下原发性肩袖修复术后的前瞻性评估。
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Efficacy of Infraclavicular Brachial Plexus Block Alone Versus Combination With Suprascapular Nerve Block in Patients Undergoing Shoulder Surgeries: A Single-Blind, Randomized Trial.锁骨下臂丛神经阻滞单独应用与联合肩胛上神经阻滞在肩部手术患者中的疗效比较：一项单盲随机试验
Cureus. 2024 Jan 25;16(1):e52961. doi: 10.7759/cureus.52961. eCollection 2024 Jan.
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Tramadol use before total shoulder arthroplasty: patients have lower risk of complications and resource utilization than those using traditional opioids.全肩关节置换术前使用曲马多：与使用传统阿片类药物的患者相比，使用曲马多的患者并发症风险和资源利用率更低。
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Patient-selection algorithm for outpatient shoulder arthroplasty in ambulatory surgery center: a retrospective update.门诊手术中心门诊肩关节置换术的患者选择算法：一项回顾性更新
J Shoulder Elbow Surg. 2024 Apr;33(4):900-907. doi: 10.1016/j.jse.2023.07.018. Epub 2023 Aug 23.
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Single-bolus injection of local anesthetic, with or without continuous infusion, for interscalene brachial plexus block in the setting of multimodal analgesia: a randomized controlled unblinded trial.多模式镇痛下单次或连续局部麻醉药注射用于肌间沟臂丛神经阻滞：一项随机对照非盲试验。
Reg Anesth Pain Med. 2024 May 7;49(5):313-319. doi: 10.1136/rapm-2023-104681.
6
Periarticular injection in addition to interscalene nerve block can decrease opioid consumption and pain following total shoulder arthroplasty: a comparison cohort study.关节周围注射联合斜角肌间沟阻滞可减少全肩关节置换术后阿片类药物的消耗和疼痛：一项对比队列研究。
J Shoulder Elbow Surg. 2023 Dec;32(12):e597-e607. doi: 10.1016/j.jse.2023.05.009. Epub 2023 Jun 11.
7
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J Clin Med. 2023 May 16;12(10):3483. doi: 10.3390/jcm12103483.
8
Rate of occurrence of respiratory complications in patients who undergo shoulder arthroplasty with a continuous interscalene brachial plexus block and associated risk factors.连续肌间沟臂丛神经阻滞下进行肩关节置换术患者的呼吸系统并发症发生率及相关危险因素。
Reg Anesth Pain Med. 2023 Nov;48(11):540-546. doi: 10.1136/rapm-2022-104264. Epub 2023 May 12.
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Balancing clinician and patient priorities for total shoulder replacement preoperative education programs.平衡全肩关节置换术前教育计划中临床医生和患者的优先事项。
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