This document discusses anesthesia considerations for shoulder replacement surgery. It begins by reviewing the anatomy of the shoulder joint and types of artificial shoulder prostheses used in replacement surgery. The key steps of the surgery are described, which involve removing the ball portion of the humerus and replacing it with prosthetic components. The document outlines that general anesthesia is typically used, sometimes with an interscalene nerve block to provide additional pain relief. Finally, it notes some potential complications of the interscalene block, such as inadvertently blocking other nerves or injecting into blood vessels.
2. Anaesthesia for shoulder
replacement surgery
Anatomy of shoulder
joint
Artificial shoulder
Steps of operation
Anaesthetic
implications
Steps in interscalene
block &it’s
complications
Complications of
shoulder replacement
surgery.
3. Anatomy of shoulder joint
1. 3 bones constitute shoulder
joint:humeral head, glenoid
of scapula, &clavicle.
2. Rotator cuff consisting of
suprsspinatus infrspinatous,
teres minor& subscapularis
connect humerus to scapula.
3. Bursa is placed between the
cuff&acromion.
4. Humeral blood vesseles
enter at the base of it’s
articular cartilage.
5. Joint capsule surrounds
humeral head & glenoid.
4. Artificial shoulder
1. 2 types of prosthesis
used:cemented &
uncemented
2. Cemented prosthesis is held
in place by a type of epoxy
cement that attaches metal
to the bone.
3. Uncemented prosthesis has
a fine mesh of holes on the
surface & bone grows into
this mesh. Over time this
anchors the prosthesis to the
bone.
4. Each prosthesis has 2 parts
humeral&glenoid.
5. Steps of the operation
1. Removal of ball portion of humeral head
with saw.
2. Cavity inside the the upper humerus is
prepared by using a rasp.
3. Currettage of any remaining cartilage in
glenoid.
4. Insertion of humeral & glenoid component
in the respective places.
5. Suturing of joint capsule & then the
overlying muscles.
