Pitfalls in regional anesthesia for shoulder surgery

Abstract

Surgeons are often reluctant to support regional anesthesia for shoulder surgery and other orthopaedic surgery. This is because the sometimes true, but usually perceived slowing down of operating room turnover times, and the perceived potential for added morbidity. The former (time issue) can only be solved by proper management, while the potential for added morbidity can be minimized by doing appropriate blocks for appropriate surgery at the correct times, when really indicated, with the correct equipment and techniques, and avoiding situations that are prone to causing morbidity. This article discusses in detail when it is appropriate to do blocks for shoulder surgery, but more important, when is it not appropriate to do blocks, and how to carefully calculate a risk-benefit ratio and avoid added morbidity.