Journal of Shoulder and Elbow Arthroplasty (Sep 2018)

Dry Catheter Technique in Shoulder Arthroplasty

  • David Gendelberg MD,
  • Susan Hassenbein CCRP,
  • H. Mike Kim MD,
  • Sanjib Adhikary MD,
  • April Armstrong MD, MSc, FRCSC

DOI
https://doi.org/10.1177/2471549218799115
Journal volume & issue
Vol. 2

Abstract

Read online

Introduction Interscalene regional anesthesia is effective for pain management but is not without complications. To determine whether postoperative neurologic findings were related to the surgery versus the regional catheter, we developed the dry catheter technique where patients could be examined after the surgery prior to dosing the catheter. The purpose of the study was to assess the utility of the dry catheter block in recognizing neurological deficits associated with regional anesthesia. Methods An interscalene catheter was placed but not started. After the surgery, a neurovascular examination was performed. If the examination was normal, the regional anesthesia was started. Throughout the patient’s hospitalization, pain levels were collected. Results A total of 125 shoulders were studied. There were 9 postoperative nerve-related complications. The patients experienced the most pain relief in the first 12 hours. Conclusion The dry catheter technique allows differentiation between complications associated with regional anesthesia versus those associated with the surgery. Although interscalene anesthesia provided effective pain control, we stopped using it because we felt its complication rate was too high.