Outpatient Shoulder Arthroplasty at an Ambulatory Surgery Center Using a Multimodal Pain Management Approach.

Autor:	Bean BA; Department of Orthopaedic Surgery (Dr. Bean and Dr. Connor), Carolinas Medical Center, and the OrthoCarolina (Dr. Connor, Dr. Schiffern, and Dr. Hamid), The Sport Medicine Center, Shoulder & Elbow Center, Charlotte, NC., Connor PM; Department of Orthopaedic Surgery (Dr. Bean and Dr. Connor), Carolinas Medical Center, and the OrthoCarolina (Dr. Connor, Dr. Schiffern, and Dr. Hamid), The Sport Medicine Center, Shoulder & Elbow Center, Charlotte, NC., Schiffern SC; Department of Orthopaedic Surgery (Dr. Bean and Dr. Connor), Carolinas Medical Center, and the OrthoCarolina (Dr. Connor, Dr. Schiffern, and Dr. Hamid), The Sport Medicine Center, Shoulder & Elbow Center, Charlotte, NC., Hamid N; Department of Orthopaedic Surgery (Dr. Bean and Dr. Connor), Carolinas Medical Center, and the OrthoCarolina (Dr. Connor, Dr. Schiffern, and Dr. Hamid), The Sport Medicine Center, Shoulder & Elbow Center, Charlotte, NC.
Jazyk:	angličtina
Zdroj:	Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews [J Am Acad Orthop Surg Glob Res Rev] 2018 Oct 23; Vol. 2 (10), pp. e064. Date of Electronic Publication: 2018 Oct 23 (Print Publication: 2018).
DOI:	10.5435/JAAOSGlobal-D-18-00064
Abstrakt:	Introduction: Early reports of outpatient shoulder arthroplasty are promising, although a paucity of outcome data exists, particularly for the outpatient shoulder arthroplasty performed at a freestanding ambulatory surgery center (ASC). Methods: A retrospective analysis of 61 shoulder arthroplasty procedures (21 consecutive outpatients and 40 inpatients) was performed. Outpatient shoulder arthroplasties were conducted at a freestanding ASC using a multimodal pain regimen without the use of regional anesthesia. The primary outcome was 90-day postoperative complication rate. Secondary outcomes included 90-day hospital admissions or readmissions, emergency department and urgent care visits, revision surgeries, mortality, postoperative pain, and functional scores. Results: No major complications, readmissions, revision surgeries, or deaths occurred in the outpatient cohort. The rate of 90-day complications was 9.5% and 17.5% for the outpatient and inpatient cohorts, respectively. All patients who had their shoulder arthroplasty as an outpatient were discharged home the day of surgery. No complications related to the outpatient protocol were observed. However, 4.8% of those who had outpatient surgery visited an emergency department or urgent care within 90 days compared with 5.0% of those who had surgery as an inpatient. Discussion: Outpatient shoulder arthroplasty can be performed safely and predictably in select patients at an ASC using a multimodal pain regimen without regional nerve block.
Databáze:	MEDLINE
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