Anesthesia, patient positioning, and patient preparation

Anesthesia

Provided that no contraindication exists, all of our shoulder arthroplasty patients undergo a preoperative interscalene block administered in the preoperative holding area by an anesthesiologist. The interscalene block serves two purposes. First, use of the block minimizes the amount of general anesthetic needed during surgery; second, it aids in postoperative pain management. Our anesthesiologists perform a single shot interscalene block under ultrasound guidance. The single shot block generally lasts 12–18 hours. General anesthesia and neuromuscular paralytic agents are then administered to all patients. Neuromuscular paralysis greatly facilitates exposure during glenoid resurfacing and can be discontinued after implantation of the glenoid component.