Intraarticular Analgesia in Shoulder Surgery

Abstract

Intraarticular Analgesia in Shoulder Surgery In Response: We thank Dr. Soeding for his interest and support of our recent manuscript (1). The majority of the cases in our report consisted of diagnostic arthroscopies and therefore immediate shoulder mobilization as part of physiotherapy was not indicated. Because patients were partially immobilized during the course of the study (surgical preference) and motor paresis via the intraarticular route does not occur this assessment was not made. Extensive information already exists in the literature as to the duration of motor blockade after mepivacaine and ropivacaine (2). We agree that in certain circumstances immediate postoperative mobilization is essential and there are several strategies to deal with analgesia including continuous outpatient interscalene brachial plexus blockade (3). While analgesia in our study was provided after a simple arthroscopy it would be interesting to investigate more painful procedures using these modalities with either active or passive range of motion. Stephen M. Klein, MD Karen C. Nielsen, MD Susan M. Steele, MD