Perioperative Pain Management in Ambulatory and Inpatient Shoulder Surgery

Zangrilli, Julian; Szukics, Patrick; Austin, Luke; Horneff, John G.

doi:10.2106/jbjs.rvw.20.00191

Cited by 5 publications

(3 citation statements)

References 108 publications

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“…Besides, there are 4 articles whose journals do not receive ranks, quartiles, or percentiles, since they received a journal IF for the first time in June 2023 (Figure 5C). [15][16][17][18]…”

Section: Discipline and Journalsmentioning

confidence: 99%

Current Status and Global Trend of Rebound Pain After Regional Anesthesia: A Bibliometric Analysis

Zhou,

Jiang,

Miao

et al. 2024

LRA

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Purpose Rebound pain after regional anesthesia, a common phenomenon when the analgesic effect wears off, has been recognized in the last a few years. The aim of this study is to analyze the status and tendency of this area in a macroscopic perspective. Methods Bibliometric analysis is the primary methodology of this study. Literature retrieval was conducted in Web of Science (WoS) Core Collection. WoS, Excel, VOSviewer and CiteSpace were employed to do the analyses and visualization. Parameters were analyzed, such as publications, citations, journals, and keywords, etc. Results In total, 70 articles in the past 10 years were identified eligible. Most articles (14 pieces) were published in 2021, followed by 2022 and 2023 with 13 articles. Researchers come from 134 institutions and 20 countries. Huang Jung-Taek, Hallym College, and USA are the most productive author, institution and country, respectively. The articles were mainly published on the top journals of anesthesiology, orthopedics and surgery. The topic of these articles is primarily about the clinical issues of rebound pain. Peripheral nerve block, brachial plexus block and femoral nerve block are the activist keywords in the area, while perioperative management, fracture surgery and outcome may become hotpots in the next years. Conclusion Our results show that the study of rebound pain after regional anesthesia starts relatively late and is in upward tendency, future studies can focus on the perioperative management and outcomes of fracture patients, and the definition and mechanism of rebound pain after regional anesthesia.

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Section: Discipline and Journalsmentioning

confidence: 99%

Current Status and Global Trend of Rebound Pain After Regional Anesthesia: A Bibliometric Analysis

Zhou,

Jiang,

Miao

et al. 2024

LRA

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“…Multimodal analgesia is a crucial part of a pathway for ambulatory TSA [23]. Low-dose ketamine (20–50 mg) can replace routine administration of intravenous opioids during shoulder surgery [5,12 ▪ ], and may reduce postoperative pain and opioid usage.…”

Section: Multimodal Analgesiamentioning

confidence: 99%

Clinical care pathways for ambulatory total shoulder arthroplasty

Dong

YaDeau

2022

Current Opinion in Anaesthesiology

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Purpose of reviewTotal shoulder arthroplasty (TSA) is growing in popularity and is increasingly done on an ambulatory basis. This review examines recent developments in anesthesia and analgesia for ambulatory shoulder surgery. Pathway components are discussed and a sample pathway is described. Recent FindingsAdoption of pathways for shoulder surgery improves patient experience by reducing pain, opioid use, and side effects while improving patient satisfaction. Long-acting nerve blockade using adjuvants like dexamethasone provide long-lasting analgesia without rebound pain. Peripheral nerve blockade provides better analgesia than peri-articular injection of local anesthetic. There are multiple approaches to nerve blockade for shoulder surgery to consider, including interscalene, superior trunk, supraclavicular, and anterior suprascapular nerve blocks. Multimodal analgesia should include acetaminophen and nonsteroidal anti-inflammatory drugs, but routine gabapentinoids should not be used.

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“…[13][14][15][16][17][18] There are multimodal pain management protocols used for TSA that include regional nerve blocks and/or local anesthetics which are aimed at reducing opioid consumption and allow for a decreased length of stay. 19 Nonetheless, opioid medications are still widely utilized to manage acute postoperative pain following TSA in both the inpatient and outpatient setting. Moreover, opioids prescribed for surgical pain pose a risk for opioid dependence, as it is estimated that 3% to 13% of opioid naïve surgical patients develop new onset prolonged opioid use.…”

Section: Introductionmentioning

confidence: 99%

No significant difference in risk of prolonged opioid use following outpatient versus inpatient total shoulder arthroplasty: A propensity matched analysis

et al. 2021

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Background The purpose of this investigation was to compare rates of filled opioid prescriptions and prolonged opioid use in opioid naïve patients undergoing total shoulder arthroplasty (TSA) in inpatient versus outpatient settings. Methods A retrospective cohort study was conducted using a national insurance claims database. Inpatient and outpatient cohorts were created by identifying continuously enrolled, opioid naïve TSA patients. A greedy nearest-neighbor algorithm was used to match baseline demographic characteristics between cohorts with a 1:1 inpatient to outpatient ratio to compare the primary outcomes of filled opioid prescriptions and prolonged opioid use following surgery between cohorts. Results A total of 11,703 opioid naïve patients (mean age 72.5 ± 8.5 years, 54.5% female, 87.6% inpatient) were included for analysis. After propensity score matching (n = 1447 inpatients; n = 1447 outpatients), outpatient TSA patients were significantly more likely to fill an opioid prescription in the perioperative window compared to inpatients (82.9% versus 71.5%, p < 0.001). No significant differences in prolonged opioid use were detected (5.74% inpatient versus 6.77% outpatient; p = 0.25). Conclusions Outpatient TSA patients were more likely to fill opioid prescriptions compared to inpatient TSA patients. The quantity of opioids prescribed and rates of prolonged opioid use were similar between the cohorts. Level of evidence Therapeutic Level III.

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Perioperative Pain Management in Ambulatory and Inpatient Shoulder Surgery

Cited by 5 publications

References 108 publications

Current Status and Global Trend of Rebound Pain After Regional Anesthesia: A Bibliometric Analysis

Current Status and Global Trend of Rebound Pain After Regional Anesthesia: A Bibliometric Analysis

Clinical care pathways for ambulatory total shoulder arthroplasty

No significant difference in risk of prolonged opioid use following outpatient versus inpatient total shoulder arthroplasty: A propensity matched analysis

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