Advertisement

Shoulder Arthroplasty: Pain Management

  • Filiz Uzumcugil
  • Fatma Sarıcaoglu
Chapter

Abstract

Shoulder arthroplasty surgery is indicated as one of the definitive treatment methods for painful glenohumeral arthritis. It has become popular due to the long-lasting pain relief; however, the pain during the early postoperative period has been a true challenge especially because of the pain associated with exercise. Early rehabilitation which is crucial after arthroplasty surgeries requires adequate pain management. In order to provide the early effective pain control, the regional anesthesia/analgesia techniques, local inflitration and systemic analgesics are recommended to be used as certain parts of multimodal analgesic treatment, whilst the analgesic protocols are suggested to be more beneficial when all discussed within a multidisciplinary team.

References

  1. 1.
    Codding JL, Getz CL. Pain management strategies in shoulder arthroplasty. Orthop Clin N Am. 2018;49:81–91.CrossRefGoogle Scholar
  2. 2.
    Goon AK, Dines DM, Craig EV, et al. A clinical pathway for total shoulder arthroplasty- a pilot study. HSS J. 2014;10(2):100–6.CrossRefGoogle Scholar
  3. 3.
    McLaughlin DC, Cheah JW, Aleshi P, et al. Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study. J Shoulder Elb Surg. 2018;27:686–91.CrossRefGoogle Scholar
  4. 4.
    Kadum B, Inngul C, Ihrman R, et al. Higher preoperative sensitivity to pain and pain at rest are associated with worse functional outcome after stemless total shoulder arthroplasty. Bone Joint J. 2018;100-B:480–4.CrossRefGoogle Scholar
  5. 5.
    Henn RF, Ghomrawi H, Rutledge JR, et al. Preoperative patient expectations of total shoulder arthroplasty. J Bone Joint Surg Am. 2011;93(22):2110–5.CrossRefGoogle Scholar
  6. 6.
    Mancuso CA, Altchek DW, Craig EV, et al. Patients’ expectations of shoulder surgery. J Shoulder Elb Surg. 2002;11(6):541–9.CrossRefGoogle Scholar
  7. 7.
    Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes. CMAJ. 2001;165(2):174–9.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Ban TCH. Interscalene block. In: Ban TCH, editor. Atlas of ultrasound and nerve stimulation-guided regional anesthesia. NY: Springer; 2007. p. 63–74.Google Scholar
  9. 9.
    Desmet M, Braems H, Reynvoet M, et al. IV and perineural dexamethasone are equivalent in increasing the analgesic duration of a single-shot interscalene block with ropivacaine for shoulder surgery: a prospective, randomized, placebo-controlled study. Br J Anaesth. 2013;111(3):445–52.CrossRefGoogle Scholar
  10. 10.
    Kawanishi R, Yamamoto K, Tobetto Y, et al. Perineural but not systemic low-dose dexamethasone prolongs the duration of interscalene block with ropivacaine: a prospective randomized trial. Local Reg Anesth. 2014;7:5–9.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Candido KD, Franco CD, Khan MA, et al. Buprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia in outpatients. Reg Anesth Pain Med. 2001;26:352–6.CrossRefGoogle Scholar
  12. 12.
    Candido KD, Winnie AP, Ghaleb AH, et al. Buprenorphine added to the local anesthetic for axillary brachial plexus block prolongs postoperative analgesia. Reg Anesth Pain Med. 2002;27:162–7.CrossRefGoogle Scholar
  13. 13.
    Popping DM, Elia N, Marret E, et al. Clonidine as an adjuvant to local anesthetics for peripheral nerve and plexus blocks: a meta-analysis of randomized trials. Anesthesiology. 2009;111:406–15.CrossRefGoogle Scholar
  14. 14.
    Iskandar H, Benard A, Ruel-Raymond J, et al. The analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy. Anesth Analg. 2003;96:260–2.PubMedGoogle Scholar
  15. 15.
    YeDeau JT, Gordon MA, Goytizolo EA, et al. Buprenorphine, clonidine, dexamethasone and ropivacaine for interscalene nerve blockade: a prospective, randomized, blinded, ropivacaine dose-response study. Pain Med. 2016;17:940–60.Google Scholar
  16. 16.
    Alemanno F, Ghısı D, Fanelli A, et al. Tramadol and 0.5% levobupivacaine for single-shot interscalene block: effects on postoperative analgesia in patients undergoing shoulder arthroplasty. Minerva Anesthesiol. 2012;78:291–6.Google Scholar
  17. 17.
    Ilfeld BM, Vandenborne K, Duncan PW, et al. Ambulatory continuous interscalene nerve blocks decrease the time to discharge readiness after total shoulder arthroplasty: a randomized, triple-masked, placebo-controlled study. Anesthesiology. 2006;105(5):999–1007.CrossRefGoogle Scholar
  18. 18.
    Sabesan VJ, Shahriar R, Petersen-Fitts GR, et al. A prospective randomized controlled trial to identify the optimal postoperative pain management in shoulder arthroplasty: liposomal bupivacaine versus continuous interscalene catheter. J Shoulder Elb Surg. 2017;26:1810–7.CrossRefGoogle Scholar
  19. 19.
    Ip V, Bouliane M, Tsui B. Potential contamination of the surgical site caused by leakage from an interscalene catheter with the patient in a seated position: a case report. Can J Anesth. 2012;59:1125–9.CrossRefGoogle Scholar
  20. 20.
    Thompson M, Simonds R, Clinger B, et al. Continuous versus single-shot brachial plexus block and their relationship to discharge barriers and length of stay. J Shoulder Elb Surg. 2017;26:656–61.CrossRefGoogle Scholar
  21. 21.
    Auyong DB, Yuan SC, Choi DS, et al. A double-blind randomized comparison of continuous interscalene, supraclavicular, and suprascapular blocks for total shoulder arthroplasty. Reg Anesth Pain Med. 2017;42:302–9.CrossRefGoogle Scholar
  22. 22.
    Girdler-Hardy TP, Webb C, Menon G. Improved safety and efficacy of ultrasound-guided interscalene nerve block vs a nerve-stimulator guided-technique. Br J Anaesth. 2015;115(3):474–5.CrossRefGoogle Scholar
  23. 23.
    Careskey M, Naidu R. Continuous suprascapular nerve block with a perineural catheter for reverse shoulder arthroplasty rescue analgesia in a patient with severe chronic obstructive pulmonary disease. A&A Case Rep. 2016;7:37–40.CrossRefGoogle Scholar
  24. 24.
    Boezaart AP, Bigeleisen P. Applied macroanatomy of the upper extremity nerves above the clavicle. In: Boezaart AP, editor. The anatomical foundations of regional anesthesia and acute pain medicine. Sharjah: Bentham Science; 2016. p. 3–27.Google Scholar
  25. 25.
    Flaherty JM, Auyong DB, Hanson NA. Bilateral continuous suprascapular nerve blocks for bilateral shoulder hemiarthroplasty. A&A Case Rep. 2016;7:125–8.CrossRefGoogle Scholar
  26. 26.
    Fredrickson MJ, Krishnan S, Chen CY. Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques. Anaesthesia. 2010;65(6):608–24.CrossRefGoogle Scholar
  27. 27.
    Panchamia JK, Olsen DA, Sanchez-Sotelo J, et al. Combined selective nerve blockade and local infiltration analgesia in a total shoulder arthroplasty patient with chronic pain and severe restrictive lung disease: a case report. A&A Case Rep. 2017;9:360.  https://doi.org/10.1213/XXA0000000000000617.CrossRefGoogle Scholar
  28. 28.
    Ban TCH. Supraclavicular block. In: Ban TCH, editor. Atlas of ultrasound and nerve stimulation-guided regional anesthesia. New York: Springer; 2007. p. 75–85.Google Scholar
  29. 29.
    Bjornholdt KT, Jensen JM, Bendtsen TF, et al. Local infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial. Eur J Orthop Surg Traumatol. 2015;25:1245–52.CrossRefGoogle Scholar
  30. 30.
    Hannan CV, Albrecht MJ, Ptersen SA, et al. Liposomal bupivacaine vs interscalene nerve block for pain control after shoulder arthroplasty: a retrospective cohort analysis. Am J Orthop. 2016;45(7):424–30.PubMedGoogle Scholar
  31. 31.
    Okoroha KR, Lynch JR, Keller RA, et al. Liposomal bupivacaine versus interscalene nerve block for pain control after shoulder arthroplasty: a prospective randomized trial. J Shoulder Elbow Surg. 2016;25(11):1742–8.CrossRefGoogle Scholar
  32. 32.
    Andersen LO, Kehlet H. Analgesic efficacy of local infiltration analgesia in hip and knee arthroplasty: a systematic review. Br J Anaesth. 2014;113:360–74.CrossRefGoogle Scholar
  33. 33.
    Marques EM, Jones HE, Elvers KT, et al. Local anesthetic infiltration for perioperative pain control in total hip and knee replacement: systematic review and meta-analyses of short and long-term effectiveness. BMC Musculoskelet Disord. 2014;15:220.CrossRefGoogle Scholar
  34. 34.
    Martimbianco AL, Gomes da Silva BN, de Carvalho AP, et al. Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature. Phys Ther Sport. 2014;15(4):261–8.CrossRefGoogle Scholar
  35. 35.
    Secrist ES, Freedman KB, Ciccotti M, et al. Pain management after outpatient anterior cruciate ligament reconstruction: a systematic review of randomized controlled trials. Am J Sports Med. 2016;44(9):2435–47.CrossRefGoogle Scholar
  36. 36.
    Boddu C, Genza A, McCann PD. Bridging multimodal pain management provides 48-hour pain control in patients undergoing total shoulder replacement. J Shoulder Elb Surg. 2018;27(6S):S65–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Filiz Uzumcugil
    • 1
  • Fatma Sarıcaoglu
    • 1
  1. 1.Department of Anesthesiology and ReanimationHacettepe University School of MedicineAnkaraTurkey

Personalised recommendations