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http://dx.doi.org/10.1097/00000542-200601000-00038DOI Listing

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Objectives: Edema after shoulder arthroscopic surgery poses concerns due to its potential complications such as compartment syndrome, nerve damage, and respiratory issues. This study aimed to investigate the acute accumulation of subcutaneous fluid after shoulder arthroscopy.

Methods: A prospective cohort study, providing Level III evidence was conducted on 50 patients undergoing arthroscopic shoulder surgery under interscalene block anaesthesia from September to December 2023.

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Shoulder arthroscopic and arthroplastic surgeries are associated with significant postoperative pain, which can delay recovery and increase opioid consumption. Interscalene blocks (ISBs) are a commonly used method to manage this pain, either as single-shot injections or continuous catheter infusions (CISBs). This review synthesizes findings from studies conducted in the past five years, comparing the efficacy, complications, and outcomes of single-shot ISBs versus CISBs for postoperative pain management in shoulder surgeries.

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: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems.

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Background: Liposomal bupivacaine (LB) is a relatively novel anesthetic agent used in the management of postoperative pain in patients who have undergone shoulder surgery.

Purpose: To explore the literature on LB in the setting of shoulder surgery and assess its efficacy and utility in managing postoperative pain.

Study Design: Systematic review and meta-analysis; Level of evidence, 1.

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Interscalene blocks, commonly used for shoulder surgery analgesia, often cause transient phrenic nerve palsy, leading to hemi-diaphragmatic paresis. This complication is particularly problematic in patients with pulmonary comorbidities and has been extensively investigated. However, its impact on patients with Fontan physiology remains less understood with limited representation in the literature.

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