Abstract
It is not often that the patient, surgeon and hospital management are happy about the same service. However, day-case surgery is an exception, as it has well recognised cost-effectiveness. The new day-surgical shoulder arthroscopy service was audited from its commencement in August 2008 until April 2010. The objectives were to see if patients were going home the same day.
All data was gathered retrospectively via the hospital's online database and the patients' notes were collected. An Excel database was created.
From August 2008 to April 2010, a total of 41 arthroscopies were performed on 41 patients. Consultant K.A. was the operator in each case. In all cases, an interscalene nerve block was attempted by a consultant anaesthetist. All patients received endotracheal intubation and they were placed in a ‘beach-chair’ position. 49% of patients were male and 51% female. Age range was from 17-70 and the average age was 51 years. 66% underwent a sub-acromial decompression and the remainder had a cuff repair. There were two unplanned admissions due to an ineffective interscalene nerve block and the other patient suffered from paranoid schizophrenia and his carer was unavailable. All patients that went home did not re-attend as an emergency. There were no adverse events documented.
After discussion with senior staff, we conclude that this service is working well. Key facets of this service are that it should be consultant led with a familiar team, adhere to the standard day-surgical criteria and use interscalene nerve analgesia. The use of continuous regional anaesthetic infusion pumps may improve patient comfort, as reports suggest that they have some advantages. This service shall be re-audited in 2 years time.
