Anesthesia and Pain Control
A combination of general anesthesia (asleep during the procedure) and regional anesthesia (numb in the shoulder area) may be used during shoulder replacement surgery. These are described in more detail below.
Your surgeon will likely ask your anesthesiologist to administer a nerve block prior to the surgery for optimal pain management. This is called an interscalene block and it provides excellent surgical anesthesia in a safe, effective manner. The nerve block helps with pain management, and decreases the amount of narcotic pain medication needed after surgery (which in turn minimizes sedation, constipation, and the risk for feeling nauseated).
Ultimately, this promotes early recovery and facilitates a faster discharge from the hospital.
With general anesthesia, you are put completely to sleep and your breathing must be supported with a breathing tube. A machine will be used to breathe for you. Your heart and respiratory rate will be closely monitored during surgery. Potential side effects of general anesthesia generally include the following: a sore throat, hoarseness from the breathing tube, drowsiness, headache, and nausea.
Once you are in the operating room and monitored, the anesthesiologist will administer medications to relax you. He then uses an ultrasound machine to locate a bundle of nerves, then using a very thin needle (it sounds much worse than it is) injects a local anesthetic near the nerves.
Some patients will receive a one-time injection in to the side of their neck–this is called a “single shot nerve block”. Some patients will receive what is called a “continuous nerve block” via a small catheter (tube) placed into the space to slowly drip local anesthetic medication after the surgery to help with pain control. The medication will be continuously delivered for at least the first 24 hours after surgery. Patients can expect varying degrees of pain control.
When your surgery is over, you may notice a few things: first, you likely will not be able to move or feel your shoulder, arm, and sometimes even your hand. Your voice may be hoarse. Your arm may feel tingly. All of these experiences are normal and will disappear as the nerve block wears off.