Information Prior To Surgery

You will be advised by the hospital the approximate time of arrival on the day of surgery. You must not eat or drink for 6 hours before surgery. However, you may be allowed to have clear drinks (water or black tea) up to 2 hours before the proposed surgery. This can be discussed further when the anaesthetist sees you. You should take your usual medications (unless directed otherwise) on the morning of surgery with small sip of water. Rings should be removed from the arm that is to be operated on. This is for infection control purposes and to avoid tightness in the event of swelling that may occur following surgery.

What to bring with you

• Any current medication you are taking
• Dressing gown and slippers
• Toiletries
• Books, magazines or other entertainment

Arrival on the ward

You will be taken to your room and asked to change into a hospital gown. Before the operation I will see you to talk through the operation again, answer any remaining questions you may have and obtain your consent for the operation if not already completed. The side of the operation (left or right arm) will be checked with you and marked with a pen. The anaesthetist will see you and discuss the anaesthetic plan of care for your procedure.

The anaesthetic

If you are having shoulder surgery, this will usually be performed under general anaesthesia with the addition of a (interscalene) nerve block. The nerve block is a small ultrasound guided injection in the lower neck, given after or before you are asleep, that numbs the shoulder and the arm. This provides very good pain relief during and after the operation. This means that less anaesthetic drugs are required during surgery allowing for a faster recovery and less sickness and drowsiness. The nerve block will continue to provide pain relief that will last for several hours after surgery (usually 6-12 hours, occasionally up to 24 hours).

This means that until the block wears off you will have very little or no sensation in your arm and no strength. It is important therefore that you keep your arm in the sling and pay special attention to not accidentally damage your arm while you can’t feel it. Interscalene blocks are not always completely effective because sometimes the local anaesthetic does not spread to all the nerves. If the block does not work sufficiently you will be given other painkillers. Details of the nerve block will be discussed with the anaesthetist on the day of surgery.