Your Day of Surgery - Surgical Guide to Left Total Shoulder Replacement

When you enter the HSS main lobby, the receptionist at the information desk will direct you to Patient Access Services. There, the admitting assistants will complete your admission process and give you a hospital I.D. bracelet. You and your family member or support person will be directed to the 4th floor and remain in the waiting area until you are called to the pre-surgical unit. After you are called, they may stay in a nearby Family Waiting Room.

• In the pre-surgical unit you will be greeted by the nursing staff and change into a hospital gown. Your clothes and personal possessions will be labeled and held by the security staff.
• Your height, weight, and vital signs (temperature, pulse, respiration, and blood pressure) will be taken by the nursing staff, who will wash and prepare the surgical site area.
• When you are ready for surgery, your surgical team will introduce themselves to you. These include the assisting physicians, anesthesiologist, physician assistant, and nurse. Each member of this group will have already reviewed your medical record in light of their own role in your surgery. They will discuss key aspects of your health as they relate to your surgery and explain the procedures. This is an excellent time for you to ask any last minute questions about your surgery that you may have thought of since your last contact with your physician.
• “Sign your site.” Your surgeon will initial the shoulder on which he/she will operate. Two other team members will also confirm the site before surgery.
• An intravenous infusion (IV) will be started by a nurse. The IV line provides a route for fluids, medications, and antibiotics, as necessary, and also for sedatives.
• Your anesthesiologist will see you prior to surgery in order to review your physical condition and discuss the anesthesia you will receive. Feel free to ask any questions you may have about your anesthesia.
• Regional anesthesia, normally used for shoulder surgery, is fully reviewed. If you feel comfortable about anesthesia based on prior experience or knowledge, you may want to pass by those pages.
• Initial sedation: At the proper time you will be mildly sedated (via the IV) to minimize pain from the local anesthesia injection which follows and to reduce possible anxiety and tension. A general feeling of relaxation will follow this procedure.
• Injection for regional anesthesia: The regional injection is administered after the initial sedation and local injection. You will gradually lose feeling in your shoulder and upper arm, but your forearm and hand are usually affected. To monitor this process, the anesthesiologist may ask you questions about how you feel also. Shortly thereafter, you will be taken into the operating room.
• In the operating room: During surgery, you may remain awake or be sedated if you chose to not be aware of the procedure. If awake, you may hear the operating team talk among themselves. You may answer questions about how you feel, and you may talk if you wish. When surgery is complete, you will moved to the recovery room. Surgery typically takes 1.5 - 2 hours.
• In the recovery room: The nursing staff and your anesthesiologist will monitor your return to full awareness and medical clearance to be transferred to an inpatient floor. You may begin rehabilitation as instructed by your surgeon and therapist if appropriate.
• Inpatient floor: Nursing staff, anesthesiologist, and medical doctors will continue to monitor your recovery and pain management. You may begin/continue rehabilitation as instructed by your surgeon and therapist.