Manipulation Under Anesthesia (MUA) – Shoulder
Anesthesia Implications
Position: Supine, arms free at side
Time: 5-30 min (very short)
Blood Loss: Zero
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No
Anesthetic Approaches
- MAC, Propofol Push
MAC – These are typically handled as a MAC. Some will give fentanyl + versed and then follow with a careful propofol push.
Paralytic – In some cases, despite being sedated, are still “tight”. For that reason, some opt to give a small dose of short acting muscle relaxant (ie. succinylcholine) and assist ventilation as needed.
The patient will usually stay in the bed they came in. After sedation is achieved, the surgeon will manipulate the arm well past the points that were previously painful. This is to free up connective tissue etc. that is restricting normal range of motion. The surgeon will often follow with a steroid injection.
