Arthroscopic Shoulder Surgery: Is Day Surgery Possible? - A Single Institution Analysis-

Purpose: This study examined the status of arthroscopic shoulder surgery in ambulatory settings by analyzing a single institutional database.Materials and Methods: Three hundred and eight arthroscopic shoulder surgeries performed between June 2022 and March 2023 were reviewed retrospectively.Propensity score matching (1-to-2) was performed between the day surgery group and the inpatient group according to sex, age, tear size, and interscalene nerve block (ISNB).Finally, 59 patients in the day surgery group and 118 patients in the inpatient group were matched.The indications of the day surgery were pre-determined according to the American Society of Anesthesiologists classification I or II, and the patient's social, medical, and surgical factors were thoroughly analyzed to define the target group of the day surgery.Complications related to voiding difficulty were prevented by classifying the patients using the International Prostate Symptom Score (IPSS) before surgery, and preventive medications were prescribed in the higher-risk patients with an IPSS of more than 7. To reduce postoperative pain, ISNB and patient-controlled analgesia (PCA) were applied to all patients during the study period, while day surgery patients received an additional bolus injection (5 cc of 0.375% ropivacaine+5 cc of normal saline) before discharge instead of continuous ISNB PCA.This study compared the postoperative pain assessments at discharge and on postoperative days 1, 2, and 14, as well as the total volume of saline irrigation, surgical time, and complications between the day surgery and inpatient groups.Results: The visual analogue scale for pain (pVAS) at the time of surgery were comparable in the day surgery group (4.11.5) and inpatient surgery group (4.11.1), with no significant difference between them (p=0.35).Similarly, the postoperative pVAS at 1, 2, and 14 days postoperatively was similar in the two groups (all p>0.05).The surgical-related factors, such as the total volume of saline irrigation and surgical time, were similar in the two groups.Furthermore, there was no significant difference in postoperative complications between the two groups (all p>0.05).Conclusion: These results show that arthroscopic shoulder surgery in ambulatory settings is a safe alternative to inpatient surgery.