Total shoulder arthroplasty (shoulder replacement) can cause severe postoperative pain. Commonly, patients receive general anesthesia with interscalene block (injection of local anesthetic or numbing medicine near nerves in the shoulder) during surgery. As a result of the interscalene block, patients often experience sensory and motor blockade. The purpose of this study is to determine the effects of the interscalene block on the anterior deltoid muscle and hand grip strength after total shoulder arthroplasty.
Total shoulder arthroplasty can cause severe postoperative pain. Pain management includes general anesthesia with interscalene block during surgery and intravenous (IV) hydromorphone patient controlled analgesia (PCA) and oral opioid analgesics given after surgery. Side effects, such as motor blockade, may impair participation in physical therapy and diminish patient satisfaction. In order to prepare for a future study that will examine what mixtures of adjuncts/additives will best prevent recovery room pain and minimize motor blockade, the investigators are conducting this pilot study to collect preliminary data on current practice. The investigators believe the current regimen will provide adequate pain relief, but may cause extensive motor blockade and reduce patients' muscle strength after surgery.
Study Type
OBSERVATIONAL
Enrollment
10
Hospital for Special Surgery
New York, New York, United States
Anterior Deltoid Strength
Anterior deltoid strength as measured by a dynamometer. Percentage change in measure as compared to post-surgery (with post-surgery measure at 0%).
Time frame: 2 days postoperatively
Hand Grip Strength
Hand grip strength as measured by a dynamometer. Percentage change in measure as compared to post-surgery (with post-surgery measure at 0%).
Time frame: 2 days postoperatively
Number of Participants With Reduced Sensation in a Dermatome
Pin-prick sensation assessed.
Time frame: 2 days postoperatively
Numeric Rating Scale (NRS) Pain Scores With Movement
NRS pain scores (0-10; 0 = no pain, 10 = worst pain possible) assessed.
Time frame: 2 days postoperatively
Total Oral Opioid Intake in 48hrs
Opioid Usage
Time frame: 0-48hrs
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