No abstract

Shoulder arthroscopy requires a large of irrigation for a better surgical view, leading circulatory overload. This study was performed to prove whether pulmonary edema will be lead by a large of irrigation. General anesthesia with interscalene block was induced before operation. The primary outcome was ultrasound evaluation of B lines from the time before nerve block to the time 10 hours after operation. The secondary outcomes included oxygenation index, arterial partial pressure of carbon dioxide, visual analogue scale, muscle strength grade. A total of 93 patients were evaluated. Before surgery, B lines failed to be detected. While the highest total incidence of B lines was 49.4%, occurred at 4 hours after surgery. The highest incidences of severe and moderate pulmonary edema were 3.2% ( P = .081) and 9.7% ( P = .002), respectively. B lines were also found on both the affected and healthy side. During operation, the incidence of type 1 respiratory failure was 5.4% ( P = .023) and that of both type 1 and 2 respiratory failure were 6.5% ( P = .013). Pain was relieved in 6 hours after surgery (VAS < 3). At 12 hours after operation, the VAS of resting and motion were 4.68 ± 2.27, 6.90 ± 2.43, respectively. While the grade of muscle strength was 4.48 ± 0.51 at 12 hours after operation. There is a high incidence of pulmonary edema in shoulder arthroscopy, and ultrasound is a convenient tool to evaluate this complication. Pain is relieved in 6 hours after surgery by nerve block. While muscle strength can also recover at 12 hours after surgery.

Purpose : Shoulder arthroscopy requires a large of irrigation for a better surgical view, resulting in circulatory overload. This study was performed to p rove whether pulmonary edema will be lead by a large of irrigation . Materials and Methods : General anesthesia with interscalene block was induced before operation. The primary outcome was ultrasound evaluation of B lines from the time before nerve block to the time 10 hours after operation. The secondary outcomes included oxygenation index, arterial partial pressure of carbon dioxide, visual analogue scale, muscle strength grade. Results : A total of 93 patients were evaluated. Before surgery, B lines failed to be detected. While the highest total incidence of B lines was 49.4%, occured at 4 hours after surgery. The highest incidence s of severe and moderate pulmonary edema were 3.2% (P=0.081) and 9.7% (P=0.002), respectively. B lines were also found on both the affected and healthy side. During operation, the incidence of type 1 respiratory failure was 5.4% (P=0.023) and that of both type 1 and 2 respiratory failure were 6.5% (P=0.013). Pain was relieved in 6 hours after surgery (VAS<3). At 12 hours after operation, the VAS of resting and motion were 4.68±2.27, 6.90±2.43, respectively. While the grade of muscle strength was 4.48±0.51 at 12 hours after operation. Conclusions : There is a high incidence of pulmonary edema in shoulder arthroscopy, and ultrasound is an convenient tool to evaluate this complication . Pain is relieved in 6 hours after surgery by nerve block. While muscle strength can also recover at 12 hours after surgery.

A number of complications have been ascribed to shoulder arthroscopy, but pulmonary edema is rarely reported. A 64-yearold female underwent right shoulder arthroscopic repair for supraspinatus and subscapular tears under intermuscular sulcus brachial plexus block (ISBPB) and general anesthesia. Finishing suture of torn tendon, and acromion and distal clavicle plasty, the patient represented the symptoms of dyspnea, and oxygen saturation quickly dropped to 80% without oxygen supply. After inhaled oxygen, the oxygen saturation quickly returned to 95%, while dyspnea didn't improve. Noticing swelling in neck and chest, left movement of the trachea, low breath sounds and wet rales during auscultation, ultrasound examination was performed and found the obvious pleural slip, and a large number of b-lines in the lung, indicating pulmonary edema. After injection of furosemide and dexamethasone (i.v.), the outcome of patient was satisfactory. This is the first report of pulmonary edema as a complication of shoulder arthroscopy, which also reviews the relevant factors of fluid extravasation, and highlights the good use of the equipment at hand to quickly judge the patient's condition.