Suhail Karkabi M.D., , Michael Besser, F.R.C.S. and Chaim Zinman M.D.
Unit of Arthroscopic Surgery, Rambam Medical Center, Haifa, Israel
Shoulder arthroscopy is usually performed under general anesthesia or interscalene block. General anesthesia may be contraindicated and interscalene block sometimes fails. We had 8 patients who were at high-risk and, therefore, shoulder arthroscopy and decompression were performed under local anesthesia in the beach-chair position. We used 50 mL of 1% lidocaine; 30 mL were infiltrated into the skin and underlying tissues and into the glenohumeral joint, and the rest was infiltrated into the subacromial joint. Before the infiltration, all patients were given 5 mg midazolam and 0.1 mg fentanyl intravenously. All 8 patients were satisfied with the analgesia provided by the anesthesia. We conclude that arthroscopy and subacromial decompression can be readily performed under local anesthesia in combination with efficient sedation.
Arthroscopy: The Journal of Arthroscopic & Related Surgery Volume 21, Issue 11 , November 2005, Pages 1404.e1-1404.e2.