Local, regional or general anesthesia?

In recent years, we have witnessed a spectacular advancement in anesthesia techniques. The current trend is to perform an increasing number of interventions without general anesthesia, instead using only blocks or local (injections of anesthetics into the surgical site), regional (anesthesia of the peripheral nerves) or spinal (or sometimes epidural) anesthesia. Thus most arthroscopic interventions of the shoulder, elbow and knee can be performed without general anesthesia. Light sedation (anti-anxiety medication) is sometimes administered to relax or make the patient comfortable.

These techniques usually reduce complications and shorten recovery time after surgery.

In recent years, I have had the privilege of contributing to the advancement of clinical research by developing new local anesthesia techniques during shoulder surgeries. They are very beneficial in patients for whom other types of anesthesia are too risky. This new expertise was the subject of an article published in “THE JOURNAL OF SHOULDER AND ELBOW SURGERY” in September 2009.



Nonetheless, general anesthesia is still a fine solution for some interventions. In order to find the most appropriate type of anesthesia for a person, a preoperative discussion with the specialist is essential.