Journal
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
Volume 25, Issue 6, Pages 647-652Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.arthro.2009.01.019
Keywords
Pain pump; Shoulder; Chondrolysis; Arthroscopy; Glenohumeral
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Shoulder arthroscopy has become a routine Outpatient surgery. Pain control is a limiting factor for patient discharge after Surgery, and several modalities are used to provide continued analgesia postoperatively. Regional anesthetic blocks and shoulder pain pumps are common methods to provide short-term pain control. Shoulder pain pumps can be used either in the subacromial space or within the glenohumeral joint. Several clinical studies suggested-which was confirmed by a bovine and rabbit cartilage study-that there is significant chondrotoxicity from bupivacaine, a local anesthetic commonly used in pain pumps. Postarthroscopic glenohumeral chondrolysis is a noninfectious entity associated with factors including use of radiofrequency thermal instruments and intra-articular pain Pumps that administer bupivacaine, but there have been no cases reported with subacromial pain Pump placement. Treatment options are difficult in a young patient with postarthroscopic glenohumeral chondrolysis, and understanding the literature with regard to risk factors is paramount to counseling patients and preventing this devastating complication.
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