Total shoulder arthroplasty (TSA) has traditionally been performed as inpatient surgery to provide adequate postoperative
analgesia via intermittent opioid administration. We developed a regional model for ambulatory TSA using continuous brachial
plexus nerve block (CBPNB). We asked whether this regional model would allow us to select patients to undergo outpatient TSA
using CBPNB while providing similar outcomes to those patients who were managed with CBPNB and a one-night or longer inpatient
hospital stay. Of 16 selected patients, eight underwent outpatient TSA/CBPNB while the other eight had an overnight hospital
stay. Outcome measures included readmission, duration of CBPNB use, pain scores, adjunctive analgesia use, range of motion,
and patient satisfaction. There were no readmissions. Patients used CBPNB for an average of 6 days. The average postoperative
pain score was 1/10. One patient required oral analgesics while using CBPNB. All patients were very satisfied (Likert scale)
and would have the surgery again. Although these data are preliminary, the development of a regional outpatient model for
TSA using CBPNB permitted integration of community care and patient satisfaction and decreased length of hospital stay.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.