Detection and Prevention of Nerve Injury in Shoulder Arthroplasty Surgery
Neuropathy, Nerve Injury
About this trial
This is an interventional prevention trial for Neuropathy focused on measuring nerve monitoring, automated somatosensory evoked potential, nerve injury
Eligibility Criteria
Inclusion Criteria:
- Adult elective patients undergoing total shoulder arthroplasty surgery using general anesthesia
Exclusion Criteria:
- Patients unable to perform complete neurological examination
- Patients who refuse to participate
- Unable to obtain informed consent.
- Patients who are contraindicated for (or unable to perform) SSEP monitoring
- Patients who have known pre-existing peripheral neuropathy or brachial plexus injury
- Patients who are contraindicated to brachial plexus block
Sites / Locations
- London Health Sciences Centre
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Automated SSEP Monitored Group
Standard Group
SSEP monitored group: When a nerve alert is signaled by the automated SSEP device, the surgeon will be informed with the aim to reverse the signal changes. The possible surgical interventions include repositioning the operative arm into a more neutral position, avoidance of excessive traction, removal of retractors, and using a smaller implant to avoid over-correction/traction. The actual intervention will depend on the possible mechanism of nerve injury and treated accordingly.
The automated SSEP device will be connected and will be blinded to the surgeon. The screens of the automated SSEP device will be covered by an opaque plastic bag and the alarms will be turned off. No intervention is planned for this group.