Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .
Early Experience With Continuous Cervical Paravertebral Block Using a Stimulating Catheter
Background and Objectives : This study reports our early experience with continuous  cervical paravertebral block ( CCPVB  ) using a stimulating catheter for the management of acute pain after shoulder surgery . Methods : This prospect i ve observational study presents 256 CCPVB for pain relief after 14 different shoulder operations . Surgery was performed under general anesthesia and blocks were placed prior to induction of general anesthesia ( n = 81 [ 32 % ] ) , after induction of general anesthesia ( n = 116 [ 45 % ] ) , or postoperatively in the recovery room ( n = 59 [ 23 % ] ) . A bolus dose of 30 mL of 0.5 % ropivacaine was followed by an infusion of 0.1 mL/kg/h of 0.2 % ropivacaine . Patient- or nurse-initiated bolus doses of 10 mL of the same drug were used for breakthrough pain and rescue analgesics were available . Postoperative pain , patient satisfaction , and motor function in different parts of the upper limb were evaluated immediately after surgery ( time 0 ) , and then 6 , 12 , 24 , 48 , 60 hours , and 14 days postoperatively . Results : An average of 2 ( range 1 - 7 ) attempts were needed to advance the catheter while still stimulating the nerve . Average postoperative pain ranged from 0.27 ± 1.04 cm to 0.78 ± 1.56 cm ( mean ± SD ) on a visual analog scale ( VAS ) ( 0 - 10 cm ) for the first 48 hours and 3.8 ± 2.1 cm and 3.5 ± 2.4 cm at 60 hours and 14 days , respectively . Patient satisfaction on a VAS of 0 to 5 was 4.19 ± 1.1 , 4.28 ± 1.01 , and 4.69 ± 1.05 at times 0 , 6 hours , and 14 days , respectively . Motor function returned to normal in the fingers within 24 hours and in the shoulder within 60 hours . Complications included Horner 's syndrome ( 40 % ) , dyspnea ( 8 % ) , superficial skin infection ( 5 % ) , posterior neck pain ( 22 % ) , subclavian artery puncture ( 1 % ) , contralateral epidural spread ( 4 % ) , and 8 % of the patients complained of an unpleasant “ dead feeling ” of the arm . Ninety-one percent of patients would request CCPVB again for future shoulder surgery . There was no evidence of nerve damage
Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .