Patients who had arthroscopic shoulder surgery with the provision of an inter-scalene nerve block (ISB) at Blackpool Teaching Hospitals, were previously required to remain in hospital overnight. We introduced a new protocol that allowed same day discharge following arthroscopic shoulder surgery under general anaesthesia and ISB. The aim of this study was to review the outcome of this change in practice. Our results indicated that providing a discharge protocol for patients having arthroscopic shoulder surgery with the inclusion of ISB can avoid unnecessary overnight stay and enable significant cost savings, without detriment to patient safety or satisfaction.
Al-KaisyA., McGuireG., ChanV.1998Analgesic effect of interscalene block using low-dose bupivacaine for outpatient arthroscopic shoulder surgeryRegional Anaesthesia and Pain Medicine23469–73
BainG.I., RudkinG., ComleyA.S.2001Digitally assisted acromioplasty: the effect of interscalene block on this new surgical techniqueArthroscopy1744–49
5.
BenumofJ.L.2000Permanent loss of cervical spinal cord function associated with interscalene block performed under general anaesthesiaAnaesthesiology931541–44
6.
BrownA.R., WeissR., GreenbergC.1993Interscalene block for shoulder arthroscopy: comparison with general anaesthesiaArthroscopy9295–300
7.
FredricksonM.J., KrishnanS., ChenC.Y.2010Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniquesAnaesthesia65608–24
8.
HadzicA., WilliamsB.A., KaracaP.E.2005For outpatient rotator cuff surgery, nerve block anaesthesia provides superior same-day recovery over general anaesthesiaAnaesthesiology1021001–7
9.
KinnardP., TruchonR., St-PierreA., MontreuilJ.1994Interscalene block for pain relief after shoulder surgeryClinical Orthopaedics and Related Research30422–24
10.
KongY.X., WrightG., PesudovsK.2007Horner SyndromeClinical and Experimental Optometry90(5) 336–44
11.
LemosP., PintoA., MoraisG.2009Patient satisfaction following day surgeryJournal of Clinical Anesthesia21(3) 200–5
National Health Service South East Coast2012Quality and productivity: Orthopaedic enhanced recovery programme to reduce length of hospital stay Available from: www.evidence.nhs.uk/qipp [Accessed June 2014]
14.
RiaziS., CarmichaelN., AwadI.2008Effect of local anaesthetic volume (20 vs 5 ml) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus blockBritish Journal of Anaesthesia101(4) 549–56
15.
SchnaiderI., ChungF.2006Outcomes in day surgeryCurrent Opinion in Anaesthesiology19(6) 622–29
16.
ShaikhS., ChungF., ImarengiayeC.2003Pain, nausea, vomiting and ocular complications delay discharge following ambulatory micro-discectomyCanadian Journal of Anesthesiology50514–18
17.
WilsonA.T., NicholsonE., BurtonL., WildC.2004Analgesia for day-case shoulder surgeryBritish Journal of Anaesthesiology92414–15
18.
WuC.L., BerenholtzS.M., PronovostP.J., FleisherL.A.2002Systematic review and analysis of post discharge symptoms after outpatient surgeryAnesthesiology96994–1003
