Development of a regional model of care for ambulatory total shoulder arthroplasty: a pilot study
| Autor: | S. H. Gallay, J F Baker, J. J. A. Lobo, K. Patel, K. Smith |
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| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Time Factors Sports medicine medicine.medical_treatment Pilot Projects Symposium: New Approaches to Shoulder Surgery Arthroplasty Patient satisfaction Clinical Protocols Shoulder Pain Medicine Humans Orthopedics and Sports Medicine Brachial Plexus Program Development Range of Motion Articular Pain Measurement Retrospective Studies Analgesics Pain Postoperative business.industry Shoulder Joint Nerve Block General Medicine Recovery of Function Length of Stay Middle Aged Treatment Outcome Ambulatory Surgical Procedures Patient Satisfaction Ambulatory Orthopedic surgery Nerve block Physical therapy Surgery Analgesia business Range of motion Brachial plexus Follow-Up Studies |
| Zdroj: | Clinical orthopaedics and related research. 466(3) |
| ISSN: | 0009-921X |
| Popis: | Total shoulder arthroplasty (TSA) has traditionally been performed as inpatient surgery to provide adequate postoperative analgesia via intermittent opioid administration. We developed a regional model for ambulatory TSA using continuous brachial plexus nerve block (CBPNB). We asked whether this regional model would allow us to select patients to undergo outpatient TSA using CBPNB while providing similar outcomes to those patients who were managed with CBPNB and a one-night or longer inpatient hospital stay. Of 16 selected patients, eight underwent outpatient TSA/CBPNB while the other eight had an overnight hospital stay. Outcome measures included readmission, duration of CBPNB use, pain scores, adjunctive analgesia use, range of motion, and patient satisfaction. There were no readmissions. Patients used CBPNB for an average of 6 days. The average postoperative pain score was 1/10. One patient required oral analgesics while using CBPNB. All patients were very satisfied (Likert scale) and would have the surgery again. Although these data are preliminary, the development of a regional outpatient model for TSA using CBPNB permitted integration of community care and patient satisfaction and decreased length of hospital stay.Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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