Poster 163: The Effect of Subacromial Epinephrine Injection on Visualization during Shoulder Arthroscopy

Objectives: Arthroscopic technique is used to treat an increasingly wide variety of pathologic conditions the shoulder. Adequate visual clarity imperative for safety and efficacy these procedures. Addition epinephrine arthroscopic irrigation fluid has been shown improve surgeon-rated clarity, but also increases cost procedure carries potential rare, serious, cardiovascular adverse events as total dose increases. We utilize a preoperative subacromial injection containing during shoulder surgery, thereby limiting added fluid. Methods: performed double-blinded, randomized controlled trial (institutional IRB approved registered with clinicaltrials.gov) include all adult patients undergoing surgery requiring visualization space in seated upright (i.e., beach chair) position. into bupivacaine alone control group versus combination study group. Epinephrine was first fifteen liters patients. Primary outcome throughout using analog score (VAS; 1 10). A power analysis determined need minimum sample size each ensure adequate given that minimal clinically significant difference established prior studies be two points. Secondary outcomes included increase pump pressure visualization, operative time intraoperative use blood-pressure modulating medications. documented any perioperative period Results: Sixty (n = 60) were enrolled study, thirty 30) groups. Rotator cuff repair 88% cases (25 30 (83%) study; 28 (93%) control) multiple procedures 85% (24 (80%) 27 (90%) control). There small improvement neither statistically nor (8.3 ± 1.4 7.5 1.9 control, p 0.09). no (8 (27%) 7 (23%) 1.0), (62.1 19.4 min 64.1 31.0 0.86), or medications (20 (67%) 17 (57%) 0.6). either Conclusions: Performing results surgery. secondary outcomes, including change time, blood- However, there group, suggesting addition safe perform.