Anesthesia in shoulder arthroscopy

Abstract

Surgical procedures in shoulder arthroscopy can be performed under regional blockade, general anesthesia, or a combination of the two techniques. The anesthesiologist’s preoperative assessment is crucial to the formulation and execution of the anesthetic plan. The patients must be evaluated for coexisting medical problems, potential airway management difficulties, and considerations related to intraoperative positioning. This evaluation together with an understanding of the surgeon’s need is used to formulate the anesthetic plan. Hypertension is the prevalent medical problem observed in elderly patients undergoing shoulder surgery. Hypertensive patients will experience wider fluctuations in blood pressure intraoperatively than normotensive individuals, especially in the beach-chair position. Noxious stimuli will lead to exaggerated hypertensive responses. Conversely, since hypertensive patients tend to be intravascularly depleted, once general anesthesia is induced, hypotension may occur. In general, hypertensive patients should continue their antihypertensive therapy perioperatively.