Peripheral Nerve Catheters After Shoulder Surgery: Do They Improve Functionality?


Continuous interscalene blocks involve the insertion of a perineural catheter along the brachial plexus to provide a continuous local anesthetic infusion with or without patient-controlled bolus dosing. Most commonly used to produce surgery-specific analgesia for major shoulder surgery, continuous interscalene blocks may also play a role in improving surgical outcomes by facilitating early physical therapy as a result of superior pain control. This article reviews the current evidence supporting the benefits of continuous interscalene blocks in improving the quality and duration of postsurgical recovery, as well as indications, contraindications, potential complications, and adverse effects. Although a limited number of studies on continuous interscalene blocks have been published, findings suggest improvements in the time to achieve set discharge criteria, pain control, and mobility that meet or exceed surgeon-defined physical therapy goals and patient satisfaction. While the benefits in terms of rehabilitation appear to be limited to the immediate postoperative period at present, the authors recommend the use of continuous interscalene blocks for postoperative pain control following major shoulder surgery.

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