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ESRA19-0091 Perioperative analgesia for shoulder arthroplasty: a critical review of current practices in a tertiary hospital
  1. A Hassan and
  2. N Bedforth
  1. Nottingham University Hospitals NHS Trust, Anaesthesia, Nottingham, UK

Abstract

Background and aims Shoulder arthroplasty (SA) can cause severe postoperative pain. Continuous catheter-based interscalene block (CISB) prolongs analgesia compared to single injection (SISB). We reviewed postoperative analgesia and side effects following CISB or SISB for SA.

Methods A retrospective review of 60 SA patients; random selection of equal numbers receiving general anaesthesia plus either CISB or SISB. Assessment of average postoperative pain and opioid requirements (converted to equivalent doses of intravenous morphine). Duration of hospital stay, postoperative oxygen administration and hypoxemia episodes (arterial oxygen saturation <92% in non COPD patients ; <88% in COPD patients) were collected from the electronic health records.

Results We reviewed 60 patients who underwent SA from September 2017 until December 2018. Pain scores were similar with no patients complaining of severe pain in either group and the majority of patients scoring no pain or mild pain throughout. Opioid requirements were modest throughout. 57% of patients in CISB group required postoperative oxygen compared with only 10% in SISB group. 20% of patients in CISB group had hypoxaemia episodes compared with 10% in SISB group.

Abstract ESRA19-0091 Figure 1

Mean post-operative pain scores (percentage) and median opioid requirements following SA

Conclusions CISB and SISB produced satisfactory analgesia. Patients receiving CISB had a higher incidence of hypoxaemia and requirement for oxygen therapy.

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