Approximately 10 years ago I was diagnosed via Kaiser Permanente Roseville California with a full tear. I went round after round with Orthopedic surgeon Mathews regarding my request to only undergo the surgery with a local anesthesia. He would only perform it under general anesthesia. He eventually informed me that it was to late to perform the corrective surgery. Now it is 2023 and I must endure this restriction of the fully torn rotator cuff for the remainder of my life. Your explanation of the local is very impressive. Best regards. Terry MacDonald, PhD, PE, Civil engineering Redding California.
Your trainees are the most luckiest ad they have a teacher who trusts them so much. I pray to ishwar that every Medical students finds a teacher like you. My pranaam to you sir 🙏🏽
I had right shoulder arthroscopy/ rotator cuff with biceps tenodesis in 2016. My left shoulder was done January 2021, and will undergo a 2nd repair October 18th. All the surgeries have had intrascalene nerve block along with general anesthesia. That’s the way to go. I’ve had about 25 major surgeries, most orthopedic, and can state that anesthesiology today is really safe for the patient and there’s nothing to be afraid of. Having the nerve block allows you to wake up without pain, and for up to 24 hours afterwards. Mine have lasted right at 24 hours and you feel the arm/shoulder feeling coming back, which is the indicator to take the pain medication the surgeon prescribed. I invested in a cold/ice machine to keep the shoulder cooled down which helps tremendously with pain management, and patient comfort. Any pre procedure fear you might have discuss with your anesthesiologist before the surgery. The medicines today are very, very safe, and the doctors well trained and experienced in the application of them.
Had the 2nd procedure on October 18th. Went smoothly and quickly. Had the intrascalene nerve block that lasted about 24 hours and wore off quietly with no major pain. Used ice cooling machine for a few days, only took a few Percocet during this time. Stopped taking them after 4 day, used Tylenol and Advil for about 2 days. I’ve stayed in my sling, exercise forearm and hand, and see surgeon tomorrow for suture removal and future physical therapy planning. My procedure was about as good as I could expect. There’s no need to fear having orthopedic surgery or anesthesia. Of course there will be pain involved, there always is, but not enough to cause someone not to get the help needed.
Thanks, this Aleve's some trepidation I have, will be getting Right shoulder arthroscopic subacromial decompression w/possible rotator cuff repair if needed Monday
I am a regional anesthesiologist and trained und Dr. Prithvi Raj. Needless to say I am a huge advocate of regional anesthesia. I have had both shoulder rotator cuff repairs repaired with just regional anesthesia and a catheter. I will take huge issue in the fact that Dr. Hadzic drove himself after a procedure. That is unacceptable. If you were in any sort of car issue post operatively it would be indefensible. I would also add that you need a huge buy in from the patient and surgeon for this. The surgeon is literally on the other side of the drape. You need to be very motivated as a patient to undergo this procedure with just a regional anesthetic. I would also add that you would need an anesthesiologist who is comfortable and adept with this procedure and anesthetic technique.
Hi Lawrence. Indeed, you were lucky to have been trained by one of the iconic mentors of regional anesthesia and pain Rx. Thank you for the comment. Agreed; it looks like that the disclaimer in the video was not sufficient to indicate that driving after surgery is not recommended/allowed. Thanks to your comment, our team has placed an additional statement to make sure that potential patients are not even remotely misguided. The personalized details of post-surgery activities were enacted to demonstrate the mental clarity advantage of regional anesthesia, and not as a recommendation. I did have an escort who took care of me to make sure I do not do anything that is not recommended. And I agree in that regional anesthesia does not work for every patient or a surgeon. But where anesthesia under blocks service is established as a standard anesthesia method, it can be far superior to general anesthesia. Finally, your last comment is also correct - one thing that all patients should know is: NEVER insist from your anesthesiologist a certain type of anesthesia that may not be his/her area of expertise. Best regards
Can you do a spinal and wrist block for an autograft from the foot to the hand ? Is there any time limits or is it more on the determined the patient is to do it that way?
Can you do a spinal and wrist block for an autograft from the foot to the hand ? Is there any time limits or is it more on the determined the patient is to do it that way?
Wow very interesting and informative. I had a shoulder repaired back in 92. Now I have another coming up. The ortho doc said my shoulder is a basket case. To many years of kick boxing, football and a state patrol officer. Paying the price for all that now. But I have a few ligaments and muscles completely torn he said from the cuff. As long as I am not in severe pain afterwards I will call it good. I have great faith in my doc. This place I go to has been excellent over the years. Can’t say enough good things about the docs there. Fantastic docs, friendly , and excel in their specialized fields. And great support and office staff. I will no t go any place else except where these professional people are. Olympia Orthopedics is AWESOME!!!!!!!!!!👍
I'm on my 5th day post op with rotator cup surgery with Expareal nerve block, I have no pain at all after surgery with bone shaving and 2 anchors installed. No pain medication taken, I feel great until its time for PT. LOL.
Hi Eddy! Thank you so much for the positive feedback. At NYSORA, we're all about making information on RA and pain medicine available to all. We plan on keeping up with videos for a long time, as well as with our other educational content that you can find on our site. Best!
I'm close to 72 hours with my pain block. I have PT schedule today. Thanks for the video. I did have general anesthesia, the deep pain in my shoulder isn't too bad. Only taken Tylenol so far.
I’m 6 weeks post rotator cuff, bicep tendon and ac joint resection. I had a spectacular anesthesiologist, I could not even feel the needle going in for the block. Surgery was 7:00 am on a Monday and that block didn’t start to wear off until Wednesday evening. Beautiful! This was far superior to oral meds as it causes N/V even with two types of antiemetics.
Nicely presented, Dr. Had my cuff repaired 2 weeks ago. Went with the technique. No catheter placed, though. Now, in the recovery and painful part..😊 Thank you again. Dr
I love your explanations brother. Thank you and I do hope for your full recovery. I am 3 months post op. Sub scap partial, Supra fill thickness w/ 2 Dermal on Demand patches, SDC, AC Incision, Bicep Tenodesis. Recovery is well on the way through PT and daily exercises. Starting strengthening at 4 months...looking at eight months after for my return to work, where I was injured. Take care
NOTE: Do NOT drive or engage in ANY financial transactions until you recover form surgery and anesthesia. You must have an escort who can help you with the transport and care for you before you can be discharged home, even after minor surgery. Some activity in this video (LABELED as NOT RECOMMENDED) are enactments to demonstrate the mental clarity after loco-regional anesthesia and should not be construed as recommendations.
I’m so happy that I researched this today. I was just told today that I have to have surgery on my right shoulder with a torn rotator cuff. My accident was 1/15 and I just had my 1st appt. after MRI. I’m also in NY at your old hospital which is now Mt. Sinai. I wonder if I will have a choice in my type of anesthesia? You were great and now I have more questions for my Dr.’s.✌🏽
Thank you for the info. Dr. Hadzic! I’m going for this surgery tomorrow. Very much appreciated🙏🏼 We miss you in St.Luke’s ( it’s renamed Mount Sinai Morningside )now.
Thanks for sharing your experience and knowledge I am Anaesthetist practicing in India and I am fan of your videos and it enriches my knowledge 👌👌👌🙏🙏🙏 Keep on doing more videos and more high lights on PNS technics
This is fascinating. I was amazed how little pain I had for my shoulder and upper arm repair surgeries as the nerve block // paralysis lasted a few days. Getting shoulder and arm surgery was worth it!
Not a compete apples to apples compassion, but thanks for a fascinating lecture from a patient who recently had 3 shoulder procedures: Distal Claviculectomy, Biceps Tenodesis, & Subacromial Bone Shaving. My anesthesiologist gave me the option of a short term block/approximately 12 to 24 hours, or long term, up 72 hours. I selected the long term option, but my Ortho didn't allow it. Curious why he disallowed the long term option. Regardless, no need for Oxycodone Acetaminophen by week 3. And the post op pain during week 1 wasn't too bad. Especially compared to the pre-op pain from no cartilage at the AC joint, and dull deep pain caused by a biceps tendon completely detached from the glenoid, and large SLAP tear.
THANK YOU FOR THIS INFORMATION!!!!! At my age, I don't ever want general anesthesia again. I came to your website to see if rotator cuff surgery can be performed with a local. Now that I see I can, I will contact my doctor and move forward.
Hi Samtani Pradeep!. Thank you for watching. Do subscribe to this channel and share with your colleagues; a lot more videos are coming up. Greetings from NYSORA!!
This is a great video, thank you very much for the information. I am 72 years old, and I was scheduled for rotator cuff repair in a couple of weeks. After watching your video I checked with my surgeon's office and found out they do not use the method that you discuss in the video. How do I find a surgeon and anesthesiologist team that uses the procedures that you describe in your video?
My husband was going to have shoulder replacement surgery. They put the shoulder block in and it went into his blood stream and almost killed him within minutes . It took them 1 1/2 hrs to bring him back . Then he was put in ICU . It was a traumatic event for both of us ! 😢
I have read several case reports of deaths due to fluid extravization during shoulder arthroscopy closing the airway with an LMA in place. I place interscalene blocks for post op pain control for all shoulder surgeries, but due to above mentioned risk I also use GA with ETT.
Hi Emery. Indeed, this technique is applicable only to surgeons who are expeditious and have predictable operating. These are folks who often do 10-15 arthroscopies/day. Blocking patients preoperatively and operating under interscalene block saves a lot of time, and gives these surgeons a lot of credit. We have been having an increasing number of patients who have a phobia of general anesthesia and seek our expertise for surgery under regional anesthesia only. Best regards.
Boy I wish I would have seen this before my surgery.. I had rotator cuff and bicep tendon repair on 3/11 they did give me a nerve block but it only lasted 18hrs at best .. I’m 16 days post op and while I AM improving I’m having a great deal of neck pain and my shoulder aches .. a 72hr nerve block would have been a godsend
Nice lesson in nerve block anesthesia I would not have surgery unless I was assured there is absolutely no pain an no recall of surgery want to be knocked out completely
I got tinnitus 5 days after rotator cuff tear surgery. I was so nausa when I woke up from anesthia. Ive had anesthia before and never was nausa like i was in this surgery.
Thanks so much for this presentation it has given me the hope of getting the surgery and having very little pain the first few days. Is this sometime offered now with most rotator cuff surgery? Thanks
Thanks for the information doc. I have a question. Is it possible to perform the procedure with an epidural catheter in case of not having the specific kit for this procedure? Thanks a lot. Kind regards from Colombia
I've calcification tendinitis innnnnnnexplicably painfull traumatising pain EVER😨😨😨...will be seeing orthopaedic surgeon soon....pain has subsided by some beautiful appreciated miracle over thee past few days.....couldn't move my arm at all😨😨😨excruciating kindv pain in every thought I could handle😢😭💔💔💔💔💔💔💔
They are giving me a choice between brachial nerve block or general. I am VERY bad with needles and have had very bad experiences with them. I don't know if I can sit still or tolerate the pain of getting the block.
The nerve block is the freakiest thing I’ve ever had done. I had carpal tunnel in both hands with a reconstructive surgery on one hand because the surgeon screwed up my first surgery. I had a full blown panic attack in pre-op and in order to go through with surgery I had to start general anesthesia in the pre-op room. When I had my next hand operated on I told them not to start the regional block until after I was put under. Never again will I allow a nerve block unless they do it in the OR
I've had a number of surgeries all involving nerve blocks and all done while conscious because they don't know if it's working properly unless u tell them it's actually working
Got my MRI results and i have a Tear of the posterosuperior/posterior labrum (7-11 o'clock), associated with a large posterosuperior paralabral cyst that partially protrudes into the spinoglenold notch. No edema or atrophy Ir suggest enervation Trom suprascapular nerve impingement. I'm in SEVERE SEVERE PAIN! Are there any Temporary relief like Cortizone shot or something until we figure out what the next steps are?
What about posterior port placement during arthroscopy do you give local infiltration for that?? And do you give superficial cervical plexus block too for this surgery??
Thanks very much for the lecture. Am an anesthetist practicing in Ghana. We don't use nerve stimulator in our regional anaesthesia practices. Please can you help me with these procedures without using nerve stimulator ( blind procedures). Thanks.
I had rotator cuff surgery and after three days from receiving the block (and surgery) only two fingers returned fully and the others still fairly numb although I can make a fist etc. The main problem is the the tingles and partial numbness. Four weeks have passed and it is still the same. Anesthesiologist said it will go away, and to wait it out. Anyone have a block lasting this long?
I am week#7 post-op, and still have the tingles, and slight numbness. The tingles run all the way down my arm, and then the slight numbness starts in my wrist, goes down the right side of my hand to my pinky, and ring fingers. I can make a fist. It just feels kinda weird.
is there a "Peripheral Nerve Blocks" book prize if u catch a mistake? :D mixed up the scalene muscles @ 17:40...though forgiveable, thanks for the educational video :) greatings from hungary
I'm having rotator cuff and bicep tendon surgery on 12/13. Which nerve block do you prefer/recommend: catheter or injection? I would like the nerve block to last as long as possible. Also, what is Xparel?
Hi Garry! Thank you for your interest in this topic. For more information, Subscribe to Nysora's Compendium of Regional Anesthesia here nysoralms.com/courses/nysora-compendium-of-regional-anesthesia/
@@nysoravideo I asked a simple question and you want me to pay a $99 subscription fee for the answer. Either get rid of this UA-cam channel or turn comments off if you'll only help paying customers.
Ohh so the cathedral stays in the neck? For shah reasons? Also, I could move my index finger when I woke up but couldn’t when I got home, about a 45 minute drive. Is that because he administered more anesthetic to the block?
Now wait a minute, is this really water in that cup, sir? Or is it perhaps some other kind of a *ahem* CLEAR LIQUID? Ksenija Proud lifelong member of team "Coffee is a clear liquid!"
I am 6 weeks after operation and still have pain in my arm like creazy , pain like SOMBODY hit me in my arm with HAMMER ,,my bone it is so painful and my veins in that arm show like a WAVES and I still on Tylenol no 3 every 4 h ,, And i am SCREMING from that pain , I will see doctor 2 nd time after my operation next week The first was 10 days and he said it is ok Sorry not ok for me 😭😢 Can SOMBODY tell me why I have to terminal pain The first 2 weeks I was on 5 mg ,morphine now eat Tylenol like candy 🤢🤢🤢make my STOMACH hurts 😲😢😢😢😢
My nerve block did not work all it made me do was lose my voice and cough for 12 hours. My surgen stoped the jerk from keeping on "pooking " me .. I got a couple shots in my shoulder when the surgen was finished. I will not EVER let that happen again...NO nerve block for me. I'm pretty sure the anesthesiologist was not very competent..
That stuff didn't work for me. Or what do they put in for my carpal tunnel 2 numb it for surgery. They put the band on my arm then put the medicine in to make my arm go numb. Went to make the incision and I about come off the table. They put me right to sleep. And that is why next week when I have my shoulder fixed. Which I have to have a full thickness tear involving the distal supraspinatus tendon with medial 1.5 CM retraction. Subscapularis and infraspinatas partial thinkness articular sided faying tear. Intrasubstance tear of the intra angular bicep tendon. and full thickness slab tear. And I need a acromioplasty. But I'm not going to let him do that this time cuz that was horrible the last time. Just put me to sleep fix it. While I'm asleep put in the catheter that keeps numbing it up after surgery and after a couple days I shouldn't need it. That's how we did my right shoulder. I didn't have a problem two things help me the most after shoulder surgery the last time. One was the ice machine made ice cold water circulator around it. And my medicalcannabis'. I hardly took a pain pill. I'm praying this time will be the same but I got a lot more damage on this left side.
Sorry to hear and thank you for the feedback. Regional anesthesia does require expertise and service, that may not be readily available everywhere. Where available, it is very valuable to patient's experience and recovery. Best regards
Carpal tunnels are just as successful with MAC and local infiltration by surgeons. Bier block offers NO advantage in my experience and is often inferior. We have 4 hand surgeons and 2 want it each way. MAC is the better choice. I had my CTR under Bier both times and it was inadequate but I remember nothing. Sedation always is necessary adjunct either way. I also had shoulder surgery with fantastic Exparel block, but would never consider having or doing it solely under block, I don't want to babysit and I don't want to deal with patients covered up having problems when port placement falls outside the dermatomes we are working on. Beach chair vs lateral shoulder surgery are different animals
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Approximately 10 years ago I was diagnosed via Kaiser Permanente Roseville California with a full tear. I went round after round with Orthopedic surgeon Mathews regarding my request to only undergo the surgery with a local anesthesia. He would only perform it under general anesthesia. He eventually informed me that it was to late to perform the corrective surgery. Now it is 2023 and I must endure this restriction of the fully torn rotator cuff for the remainder of my life.
Your explanation of the local is very impressive.
Best regards.
Terry MacDonald, PhD, PE, Civil engineering
Redding California.
Your trainees are the most luckiest ad they have a teacher who trusts them so much. I pray to ishwar that every Medical students finds a teacher like you. My pranaam to you sir 🙏🏽
Thank you for your kind words!
I had right shoulder arthroscopy/ rotator cuff with biceps tenodesis in 2016. My left shoulder was done January 2021, and will undergo a 2nd repair October 18th. All the surgeries have had intrascalene nerve block along with general anesthesia. That’s the way to go. I’ve had about 25 major surgeries, most orthopedic, and can state that anesthesiology today is really safe for the patient and there’s nothing to be afraid of.
Having the nerve block allows you to wake up without pain, and for up to 24 hours afterwards. Mine have lasted right at 24 hours and you feel the arm/shoulder feeling coming back, which is the indicator to take the pain medication the surgeon prescribed. I invested in a cold/ice machine to keep the shoulder cooled down which helps tremendously with pain management, and patient comfort.
Any pre procedure fear you might have discuss with your anesthesiologist before the surgery. The medicines today are very, very safe, and the doctors well trained and experienced in the application of them.
Thanks for sharing!
Had the 2nd procedure on October 18th. Went smoothly and quickly. Had the intrascalene nerve block that lasted about 24 hours and wore off quietly with no major pain. Used ice cooling machine for a few days, only took a few Percocet during this time.
Stopped taking them after 4 day, used Tylenol and Advil for about 2 days. I’ve stayed in my sling, exercise forearm and hand, and see surgeon tomorrow for suture removal and future physical therapy planning.
My procedure was about as good as I could expect. There’s no need to fear having orthopedic surgery or anesthesia. Of course there will be pain involved, there always is, but not enough to cause someone not to get the help needed.
Thanks, this Aleve's some trepidation I have, will be getting Right shoulder arthroscopic subacromial decompression w/possible rotator cuff repair if needed Monday
@@i8ubfrhow did your surgery go?
@@kilduce4423 It went very well and all healed now! thanks for asking
I am a regional anesthesiologist and trained und Dr. Prithvi Raj. Needless to say I am a huge advocate of regional anesthesia. I have had both shoulder rotator cuff repairs repaired with just regional anesthesia and a catheter. I will take huge issue in the fact that Dr. Hadzic drove himself after a procedure. That is unacceptable. If you were in any sort of car issue post operatively it would be indefensible. I would also add that you need a huge buy in from the patient and surgeon for this. The surgeon is literally on the other side of the drape. You need to be very motivated as a patient to undergo this procedure with just a regional anesthetic. I would also add that you would need an anesthesiologist who is comfortable and adept with this procedure and anesthetic technique.
Hi Lawrence. Indeed, you were lucky to have been trained by one of the iconic mentors of regional anesthesia and pain Rx. Thank you for the comment. Agreed; it looks like that the disclaimer in the video was not sufficient to indicate that driving after surgery is not recommended/allowed. Thanks to your comment, our team has placed an additional statement to make sure that potential patients are not even remotely misguided. The personalized details of post-surgery activities were enacted to demonstrate the mental clarity advantage of regional anesthesia, and not as a recommendation. I did have an escort who took care of me to make sure I do not do anything that is not recommended. And I agree in that regional anesthesia does not work for every patient or a surgeon. But where anesthesia under blocks service is established as a standard anesthesia method, it can be far superior to general anesthesia. Finally, your last comment is also correct - one thing that all patients should know is: NEVER insist from your anesthesiologist a certain type of anesthesia that may not be his/her area of expertise. Best regards
Can you do a spinal and wrist block for an autograft from the foot to the hand ? Is there any time limits or is it more on the determined the patient is to do it that way?
Can you do a spinal and wrist block for an autograft from the foot to the hand ? Is there any time limits or is it more on the determined the patient is to do it that way?
Confidence building narrative for patient awaiting rotator cup repair. Thanks.
Wow very interesting and informative. I had a shoulder repaired back in 92. Now I have another coming up. The ortho doc said my shoulder is a basket case. To many years of kick boxing, football and a state patrol officer. Paying the price for all that now. But I have a few ligaments and muscles completely torn he said from the cuff. As long as I am not in severe pain afterwards I will call it good. I have great faith in my doc. This place I go to has been excellent over the years. Can’t say enough good things about the docs there. Fantastic docs, friendly , and excel in their specialized fields. And great support and office staff. I will no t go any place else except where these professional people are. Olympia Orthopedics is AWESOME!!!!!!!!!!👍
Glad you are enjoying the content and thank you for sharing your experience with us. Greetings!
I am orthopedic surgeon from Saudi Arabia I must say this fantastic video I like your videos and your high standard educational materials
Thank you for watching!
I'm on my 5th day post op with rotator cup surgery with Expareal nerve block, I have no pain at all after surgery with bone shaving and 2 anchors installed. No pain medication taken, I feel great until its time for PT. LOL.
Wow i hope he keeps teaching rare to have someone this good.
Hi Eddy! Thank you so much for the positive feedback. At NYSORA, we're all about making information on RA and pain medicine available to all. We plan on keeping up with videos for a long time, as well as with our other educational content that you can find on our site. Best!
I'm close to 72 hours with my pain block. I have PT schedule today. Thanks for the video. I did have general anesthesia, the deep pain in my shoulder isn't too bad. Only taken Tylenol so far.
how long was youre surgery?
I’m 6 weeks post rotator cuff, bicep tendon and ac joint resection. I had a spectacular anesthesiologist, I could not even feel the needle going in for the block. Surgery was 7:00 am on a Monday and that block didn’t start to wear off until Wednesday evening. Beautiful! This was far superior to oral meds as it causes N/V even with two types of antiemetics.
How are you after 6 weeks? Have you lost any muscle mass?
Nicely presented, Dr.
Had my cuff repaired 2 weeks ago. Went with the technique. No catheter placed, though.
Now, in the recovery and painful part..😊 Thank you again. Dr
We wish you a speedy recovery! Thanks for your nice words.
I love your explanations brother. Thank you and I do hope for your full recovery. I am 3 months post op. Sub scap partial, Supra fill thickness w/ 2 Dermal on Demand patches, SDC, AC Incision, Bicep Tenodesis. Recovery is well on the way through PT and daily exercises. Starting strengthening at 4 months...looking at eight months after for my return to work, where I was injured. Take care
Regional Anaesthesia Rocks !!
U are a Rockstar !!
You're sooooo much appreciated trusting you're painfree now....Amen
You are so welcome!
NOTE: Do NOT drive or engage in ANY financial transactions until you recover form surgery and anesthesia. You must have an escort who can help you with the transport and care for you before you can be discharged home, even after minor surgery. Some activity in this video (LABELED as NOT RECOMMENDED) are enactments to demonstrate the mental clarity after loco-regional anesthesia and should not be construed as recommendations.
I’m so happy that I researched this today. I was just told today that I have to have surgery on my right shoulder with a torn rotator cuff. My accident was 1/15 and I just had my 1st appt. after MRI. I’m also in NY at your old hospital which is now Mt. Sinai. I wonder if I will have a choice in my type of anesthesia? You were great and now I have more questions for my Dr.’s.✌🏽
Thank you for the info. Dr. Hadzic!
I’m going for this surgery tomorrow.
Very much appreciated🙏🏼
We miss you in St.Luke’s ( it’s renamed Mount Sinai Morningside )now.
Thanks for sharing your experience and knowledge
I am Anaesthetist practicing in India and I am fan of your videos and it enriches my knowledge
👌👌👌🙏🙏🙏
Keep on doing more videos and more high lights on PNS technics
Thank you very much, more videos coming soon!
I had my shoulder done, and exparel is awesome. I didn’t need any of the pain meds they sent home with me.
Great!
This is fascinating. I was amazed how little pain I had for my shoulder and upper arm repair surgeries as the nerve block // paralysis lasted a few days. Getting shoulder and arm surgery was worth it!
how long was youre surgery? how many anchors you get?
Not a compete apples to apples compassion,
but thanks for a fascinating lecture from a patient who recently had 3 shoulder procedures:
Distal Claviculectomy, Biceps Tenodesis, & Subacromial Bone Shaving.
My anesthesiologist gave me the option of a short term block/approximately 12 to 24 hours, or long term, up 72 hours.
I selected the long term option, but my Ortho didn't allow it.
Curious why he disallowed the long term option.
Regardless, no need for Oxycodone Acetaminophen by week 3.
And the post op pain during week 1 wasn't too bad.
Especially compared to the pre-op pain from no cartilage at the AC joint, and dull deep pain caused by a biceps tendon completely detached from the glenoid, and large SLAP tear.
Thank you for the comment. Please feel free your experience - we would LOVE to hear. Best
THANK YOU FOR THIS INFORMATION!!!!! At my age, I don't ever want general anesthesia again. I came to your website to see if rotator cuff surgery can be performed with a local. Now that I see I can, I will contact my doctor and move forward.
Thanks Dr. .. from gaza
Ohh my gosh, Dr Manoj Kumar Karmakar was your visitor. Seeing two legends together.....
Hi Samtani Pradeep!. Thank you for watching. Do subscribe to this channel and share with your colleagues; a lot more videos are coming up. Greetings from NYSORA!!
This is a great video, thank you very much for the information.
I am 72 years old, and I was scheduled for rotator cuff repair in a couple of weeks. After watching your video I checked with my surgeon's office and found out they do not use the method that you discuss in the video.
How do I find a surgeon and anesthesiologist team that uses the procedures that you describe in your video?
How are you now sir? I'm 65y.o. and have had pain for a few years,I have been going to the gym for a few months and would like to get that fixed
My husband was going to have shoulder replacement surgery. They put the shoulder block in and it went into his blood stream and almost killed him within minutes . It took them 1 1/2 hrs to bring him back . Then he was put in ICU . It was a traumatic event for both of us ! 😢
Man, you did great, I’m soon getting the operation soon, big help
I have two more days before I get my rotator cuff repair
I have read several case reports of deaths due to fluid extravization during shoulder arthroscopy closing the airway with an LMA in place. I place interscalene blocks for post op pain control for all shoulder surgeries, but due to above mentioned risk I also use GA with ETT.
Hi Emery. Indeed, this technique is applicable only to surgeons who are expeditious and have predictable operating. These are folks who often do 10-15 arthroscopies/day. Blocking patients preoperatively and operating under interscalene block saves a lot of time, and gives these surgeons a lot of credit. We have been having an increasing number of patients who have a phobia of general anesthesia and seek our expertise for surgery under regional anesthesia only. Best regards.
Boy I wish I would have seen this before my surgery.. I had rotator cuff and bicep tendon repair on 3/11 they did give me a nerve block but it only lasted 18hrs at best .. I’m 16 days post op and while I AM improving I’m having a great deal of neck pain and my shoulder aches .. a 72hr nerve block would have been a godsend
Did you have any symptoms for diaphragmatic hemiparesis?
Nice lesson in nerve block anesthesia I would not have surgery unless I was assured there is absolutely no pain an no recall of surgery want to be knocked out completely
Thanks!
This isn't the dark ages
Can't needle shift position of needle as it is moving ,allowable movement range?
Dr. If a patient wants some sedation, do you use midazolam or Propofol?
By all means.
Thank you so much, very very helpful!
Glad it was helpful!
How long does the rotator cuff surgery take under general anesthesia?
And of course you rock too Dr Hadzic thank you
Where to buy your uniform?
I got tinnitus 5 days after rotator cuff tear surgery. I was so nausa when I woke up from anesthia. Ive had anesthia before and never was nausa like i was in this surgery.
Crash course😭😭 imagine the doctor who is going to operate you is watching this video one day before 💀💀💀
When do they take out the Decathitor?
Thanks so much for this presentation it has given me the hope of getting the surgery and having very little pain the first few days. Is this sometime offered now with most rotator cuff surgery? Thanks
Thanks for the information doc. I have a question. Is it possible to perform the procedure with an epidural catheter in case of not having the specific kit for this procedure? Thanks a lot. Kind regards from Colombia
I've calcification tendinitis innnnnnnexplicably painfull traumatising pain EVER😨😨😨...will be seeing orthopaedic surgeon soon....pain has subsided by some beautiful appreciated miracle over thee past few days.....couldn't move my arm at all😨😨😨excruciating kindv pain in every thought I could handle😢😭💔💔💔💔💔💔💔
Sorry.
They are giving me a choice between brachial nerve block or general. I am VERY bad with needles and have had very bad experiences with them. I don't know if I can sit still or tolerate the pain of getting the block.
I have a rotator cuff tear confirmed with an mri.
My question is when surgery is over how the catheter is removed?
I've had both shoulders done because of rotator cuff tears and I never had a catheter and I've had 5 surgeries in total
You can just pull it out..
Great video, doc!
Dear Jeffm9227, Thank you for your comment and support!
Good afternoon Sir may I ask how much the cost of this operation,,is there is operation in the Philippines hospital.
Excellent & awesome video. Loved it!
Thank you very much!
The nerve block is the freakiest thing I’ve ever had done. I had carpal tunnel in both hands with a reconstructive surgery on one hand because the surgeon screwed up my first surgery. I had a full blown panic attack in pre-op and in order to go through with surgery I had to start general anesthesia in the pre-op room. When I had my next hand operated on I told them not to start the regional block until after I was put under. Never again will I allow a nerve block unless they do it in the OR
I've had a number of surgeries all involving nerve blocks and all done while conscious because they don't know if it's working properly unless u tell them it's actually working
@@Truthbomb918 thats bully for you. For me, the sensation of the nerve block literally had me wanting to off myself. It was hell. Torture.
Got my MRI results and i have a Tear of the posterosuperior/posterior labrum (7-11 o'clock), associated with a large posterosuperior paralabral cyst that partially protrudes into the spinoglenold notch. No edema or atrophy Ir suggest enervation Trom suprascapular nerve impingement. I'm in SEVERE SEVERE PAIN! Are there any Temporary relief like Cortizone shot or something until we figure out what the next steps are?
U can get shots, mine gave a little relief max about a week and the subsequent ones lasted less until they had no effect
Impressive 👍👍👍
Thank you! Cheers!
What about posterior port placement during arthroscopy do you give local infiltration for that?? And do you give superficial cervical plexus block too for this surgery??
Is the new liposomal bupivacaine able to be rescued with intralipid in the setting of LAST? (training registrar)
Thank you Doctor for the information 👍💯
Glad you find it helpful!
Thanks very much for the lecture. Am an anesthetist practicing in Ghana. We don't use nerve stimulator in our regional anaesthesia practices. Please can you help me with these procedures without using nerve stimulator ( blind procedures). Thanks.
I had rotator cuff surgery and after three days from receiving the block (and surgery) only two fingers returned fully and the others still fairly numb although I can make a fist etc. The main problem is the the tingles and partial numbness. Four weeks have passed and it is still the same. Anesthesiologist said it will go away, and to wait it out. Anyone have a block lasting this long?
I am week#7 post-op, and still have the tingles, and slight numbness. The tingles run all the way down my arm, and then the slight numbness starts in my wrist, goes down the right side of my hand to my pinky, and ring fingers. I can make a fist. It just feels kinda weird.
Did it eventually go away?
Awesome and very useful video.
Glad you think so!
🖥 Test drive NYSORA Compendium of Regional Anesthesia: bit.ly/3gsMYdc
Books for anesthesia pleas
Visit: pocketedu.com
Very educatiive
Hi Usman, thank you for your comment. Greetings!
My spouse had both types of anesthesia.
Top demais ! God !
We do ISB + ICB with General
Your amazing thank you for explaining
Thank you 👍🏾🤎
is there a "Peripheral Nerve Blocks" book prize if u catch a mistake? :D mixed up the scalene muscles @ 17:40...though forgiveable, thanks for the educational video :) greatings from hungary
Good call! Thank you for the feedback!
Great sir
Thank you very much!
I'm having rotator cuff and bicep tendon surgery on 12/13. Which nerve block do you prefer/recommend: catheter or injection? I would like the nerve block to last as long as possible. Also, what is Xparel?
Hi Garry! Thank you for your interest in this topic. For more information, Subscribe to Nysora's Compendium of Regional Anesthesia here nysoralms.com/courses/nysora-compendium-of-regional-anesthesia/
@@nysoravideo I asked a simple question and you want me to pay a $99 subscription fee for the answer. Either get rid of this UA-cam channel or turn comments off if you'll only help paying customers.
Mine coming up on 18th.
Ohh so the cathedral stays in the neck? For shah reasons? Also, I could move my index finger when I woke up but couldn’t when I got home, about a 45 minute drive. Is that because he administered more anesthetic to the block?
Now wait a minute, is this really water in that cup, sir?
Or is it perhaps some other kind of a *ahem* CLEAR LIQUID?
Ksenija
Proud lifelong member of team "Coffee is a clear liquid!"
I am 6 weeks after operation and still have pain in my arm like creazy , pain like SOMBODY hit me in my arm with HAMMER ,,my bone it is so painful and my veins in that arm show like a WAVES and I still on Tylenol no 3 every 4 h ,,
And i am SCREMING from that pain ,
I will see doctor 2 nd time after my operation next week
The first was 10 days and he said it is ok
Sorry not ok for me 😭😢
Can SOMBODY tell me why I have to terminal pain
The first 2 weeks I was on 5 mg ,morphine now eat Tylenol like candy
🤢🤢🤢make my STOMACH hurts 😲😢😢😢😢
I had local anesthetic ,,never ever AGAIN
I thing the DEMIGE my nerv😢😢
Excellent
Hi Doug Eten! Thank you! Greetings from NYSORA!!
One of the Best !
肩袖损伤吗？
Is this lecture meant to educate non anesthesiologist?
Dear Jambo Bharti! This video is for medical practitioners and students and there is no restriction for Anaesthesia professionals only. Greetings!
That’s why you get a nerve block .. first!
Please subtitle in spanish o english f😭
Thanks for the comment. Spanish translation added and it was created automatically, so we apologise if there are any translation errors.
My nerve block did not work all it made me do was lose my voice and cough for 12 hours. My surgen stoped the jerk from keeping on "pooking " me .. I got a couple shots in my shoulder when the surgen was finished. I will not EVER let that happen again...NO nerve block for me. I'm pretty sure the anesthesiologist was not very competent..
That stuff didn't work for me. Or what do they put in for my carpal tunnel 2 numb it for surgery. They put the band on my arm then put the medicine in to make my arm go numb. Went to make the incision and I about come off the table. They put me right to sleep. And that is why next week when I have my shoulder fixed. Which I have to have a full thickness tear involving the distal supraspinatus tendon with medial 1.5 CM retraction. Subscapularis and infraspinatas partial thinkness articular sided faying tear. Intrasubstance tear of the intra angular bicep tendon. and full thickness slab tear. And I need a acromioplasty. But I'm not going to let him do that this time cuz that was horrible the last time. Just put me to sleep fix it. While I'm asleep put in the catheter that keeps numbing it up after surgery and after a couple days I shouldn't need it. That's how we did my right shoulder. I didn't have a problem two things help me the most after shoulder surgery the last time. One was the ice machine made ice cold water circulator around it. And my medicalcannabis'. I hardly took a pain pill. I'm praying this time will be the same but I got a lot more damage on this left side.
Sorry to hear and thank you for the feedback. Regional anesthesia does require expertise and service, that may not be readily available everywhere. Where available, it is very valuable to patient's experience and recovery. Best regards
Carpal tunnels are just as successful with MAC and local infiltration by surgeons. Bier block offers NO advantage in my experience and is often inferior. We have 4 hand surgeons and 2 want it each way. MAC is the better choice. I had my CTR under Bier both times and it was inadequate but I remember nothing. Sedation always is necessary adjunct either way. I also had shoulder surgery with fantastic Exparel block, but would never consider having or doing it solely under block, I don't want to babysit and I don't want to deal with patients covered up having problems when port placement falls outside the dermatomes we are working on. Beach chair vs lateral shoulder surgery are different animals
Just a quick question Whys this guy wearing a musk while talking to a camera 😂😂
Probably tore his rotator cuff wearing those custom scrubs with the sleeves that are too tight.
Those are just cuffed scrubs. Used as standard in some orthopaedic theatres.
Takes too long to get to the point !!!!!