Anesthesia for Your Shoulder Replacement Surgery
- Jen Overton
- May 28, 2025
- 8 min read
Updated: Nov 5, 2025
If you’re preparing for shoulder replacement surgery, also known as total shoulder arthroplasty, you’re likely looking forward to relieving pain and restoring mobility in your shoulder. However, the topic of anesthesia—often discussed only briefly until the day of surgery—can bring up questions or even some anxiety.
I’m here to guide you through what to expect on the day of your shoulder replacement, explain the anesthesia methods commonly used, and provide clear, honest information to help you feel confident. Depending on your overall health, this surgery can be performed as an outpatient procedure (going home the same day) or may require a short hospital stay. Let’s walk through the process together to ease your mind.
Why Anesthesia Matters for Your Shoulder Replacement
Shoulder replacement surgery involves replacing damaged parts of your shoulder joint with artificial components to improve function and reduce pain. Anesthesia ensures you’re comfortable and pain-free during the procedure, which typically lasts 1.5–3 hours. The most common approach combines general anesthesia, which keeps you asleep, with a regional nerve block—such as an interscalene block or supraclavicular block—to manage pain in your shoulder and arm afterward. This combination allows you to undergo surgery without awareness or discomfort and supports a smoother recovery, whether you go home the same day or stay in the hospital for 1–2 days.
Below, I’ll explain what happens on the day of surgery, how these anesthesia methods work, and what you might feel, so you can approach your procedure as informed and confident as possible.
Your Day-of-Surgery Anesthesia Experience
Before Surgery: Meeting Your Anesthesia Team
On the morning of your surgery, you’ll arrive at a hospital or outpatient surgical center and check into the preoperative area. If you’re healthy, have good support at home, and your surgeon agrees, shoulder replacement can often be done as an outpatient procedure, meaning you’ll go home the same day. However, if you have other health conditions (like heart or lung issues) or need additional monitoring, a hospital stay of 1–2 days may be recommended for closer observation and pain management. Your anesthesia team will discuss this with you based on your health and the surgical plan.
In the preoperative area, you’ll meet your anesthesia provider—a nurse anesthetist like me or an anesthesiologist. We’ll review your medical history, medications, and any allergies, and confirm the anesthesia plan tailored to your needs. This is your chance to ask questions or share concerns. If you’re feeling nervous, let us know—we can offer reassurance or a mild sedative to help you relax before heading to the operating room.
Regional Nerve Blocks: Interscalene and Supraclavicular Blocks
A regional nerve block, such as the interscalene block or supraclavicular block, is commonly used for shoulder replacement surgery to provide targeted pain relief during and after the procedure, reducing the need for pain medications in the early stages of recovery.
Purpose of Regional Nerve Blocks
Both the interscalene and supraclavicular blocks numb the nerves that supply sensation to your shoulder, upper arm, and sometimes part of your chest, helping you feel little to no pain during and after surgery. These blocks can provide pain relief for 12–24 hours (or longer, depending on the medication), making your recovery more comfortable and supporting early movement, which is crucial for healing. The interscalene block is more commonly used for shoulder replacement due to its precise targeting of shoulder nerves, but the supraclavicular block may be chosen in specific cases to cover a broader area or based on your anatomy.
The Process for the Interscalene Block
The interscalene block is typically performed in the preoperative area before general anesthesia, using ultrasound for precision:
Positioning: You’ll sit up or lie down with your head slightly turned to one side to expose the neck and shoulder area. We’ll help you get comfortable and guide you through each step.
Cleaning and Numbing: We clean the skin on your neck (near your collarbone) with a cool antiseptic solution. Then, we inject a small amount of local anesthetic to numb the skin, which feels like a quick pinch or sting that fades within seconds.
Ultrasound Guidance: Using an ultrasound wand (painless, like a pregnancy scan), we locate the brachial plexus nerves in your neck that control sensation in your shoulder. We then insert a small needle to deliver numbing medication near these nerves. You may feel slight pressure, but it shouldn’t be painful. The process takes about 5–10 minutes.
What You’ll Feel: After the block, your shoulder and arm may feel warm, tingly, heavy, or numb within minutes. You might also notice temporary weakness in your arm or a slightly hoarse voice, as the block can affect nearby nerves. These effects wear off as the block fades.
The Process for the Supraclavicular Block
The supraclavicular block is similar but targets the brachial plexus nerves slightly higher, just above the collarbone:
Positioning: You’ll lie flat or slightly reclined, with your head turned to one side. We’ll ensure you’re comfortable.
Cleaning and Numbing: We clean the skin above your collarbone and inject a local anesthetic, which feels like a brief sting.
Ultrasound Guidance: Using ultrasound, we locate the nerves and deliver numbing medication through a small needle. This takes 5–10 minutes and may cause slight pressure but not pain.
What You’ll Feel: Similar to the interscalene block, your shoulder, arm, and possibly part of your chest will feel numb or heavy. Temporary arm weakness or mild breathing changes (due to nearby nerves) may occur but resolve as the block wears off.
Both blocks are safe and effective, and we monitor you closely. If you’re worried about needles or sensations, let us know—we can distract you with conversation or explain each step to keep you at ease. Mild sedation is commonly used prior to administering these blocks as well, so do not worry. Your'e in great hands!
General Anesthesia: What to Expect
General anesthesia is typically used for shoulder replacement surgery to keep you fully asleep and unaware during the procedure, often combined with a nerve block for post-surgical pain relief.
Purpose of General Anesthesia
General anesthesia ensures you’re completely comfortable and pain-free, allowing your surgeon to perform the shoulder replacement with precision while you have no memory or sensation of the procedure. It also helps us manage your breathing and vital signs safely.
The Process
Getting Started: In the operating room, you’ll lie on a padded table, and we’ll place monitors to track your heart rate, blood pressure, and oxygen levels using noninvasive devices (like sticky patches or a finger clip).
Falling Asleep: We’ll give you oxygen through a gentle mask over your nose and mouth, then administer anesthesia medication through the IV. Within seconds, you’ll drift off to sleep, like taking a nap.
During Surgery: We may place a breathing tube to help you breathe safely, which you won’t feel or remember. We monitor you closely, adjusting medications to keep you stable.
Waking Up: After surgery (1.5–3 hours), we stop the anesthesia, and you’ll wake up in the recovery room. The breathing tube is removed before you’re fully awake, so you won’t notice it.
Want to learn more about General Anesthesia, click the image below to read General Anesthesia: The Patient Experience from Start to Finish.
What You’ll Feel
When you wake up, you may feel groggy, chilly, or have a dry mouth or sore throat from the breathing tube. The nerve block (interscalene or supraclavicular) will keep your shoulder and arm numb, reducing pain as you recover. These effects are temporary, and we’ll provide comfort measures like water or medication as needed.
Still worried about having general anesthesia for your shoulder surgery? Click the image below to learn tips to help keep you safe during general anesthesia.
Recovery: Outpatient or Inpatient
After surgery, you’ll spend 1–2 hours in the recovery room, where nurses monitor you as you wake up fully. The nerve block will keep your shoulder numb for several hours, helping with pain control. You’ll likely need a sling to support your shoulder, as directed by your surgeon.
If you’re having outpatient surgery—common for healthy patients with good home support—you’ll go home the same day once you’re stable, can move with assistance, and have a ride home. We’ll provide instructions for pain management (e.g., over-the-counter medications or a short-term prescription) and guidance on starting physical therapy. If a nerve block was used, be cautious with your numb arm to avoid injury until sensation returns.
If a hospital stay is needed (1–2 days), typically for patients with other health conditions or more complex surgeries, you’ll receive additional monitoring, IV pain medications if necessary, and support to start physical therapy in the hospital. Your anesthesia and surgical teams will ensure you’re prepared for either scenario.
Why This Combination Works
The combination of general anesthesia with a regional nerve block (interscalene or supraclavicular) is highly effective for shoulder replacement surgery. General anesthesia keeps you asleep and unaware during the procedure, while the nerve block provides targeted pain relief, reducing the need for strong pain medications and supporting early recovery. This approach works well for both outpatient and inpatient settings, allowing you to focus on healing and regaining shoulder function with minimal discomfort.
Alternative Anesthesia Options
Your anesthesia team will choose the best method based on your health, the procedure’s complexity, and your preferences. Alternatives include:
General Anesthesia Alone: If a nerve block isn’t suitable (e.g., due to specific medical conditions), general anesthesia alone can provide complete comfort, with pain managed afterward using medications.
Regional Block with Sedation: In rare cases, for less invasive procedures or if you prefer to avoid being fully asleep, an interscalene or supraclavicular block with sedation (instead of general anesthesia) might be used, keeping you relaxed but not fully asleep. This is less common for shoulder replacement due to the need for precise positioning.
Other Nerve Blocks: In specific cases, a different block (e.g., suprascapular nerve block) may be used alongside or instead of the interscalene or supraclavicular block, depending on the surgical plan.
Share any preferences or concerns (e.g., wanting to avoid certain side effects or managing post-surgery pain) with your anesthesia team. We’ll work with you and your surgeon to create a plan that feels right.
Tips to Prepare and Reduce Anxiety
Feeling prepared can ease your nerves and set you up for a smooth surgery. Here are some tips:
Ask Questions: Write down any concerns about anesthesia or recovery and ask them during your preoperative visit or on the day of surgery. No question is too small.
Practice Relaxation: If you’re anxious, try slow, deep breathing or visualization techniques. We can guide you through relaxation strategies if needed.
Plan for Recovery: Arrange for someone to drive you home (especially for outpatient surgery) and help with tasks for a few days. Have a sling, ice packs, or other recovery aids ready, as recommended by your surgeon.
Trust Your Team: Your anesthesia and surgical teams are dedicated to your safety and comfort. We’ll monitor you closely and adjust care to meet your needs.
Final Thoughts
Anesthesia for shoulder replacement surgery is designed to keep you pain-free and relaxed, allowing your surgeon to restore your shoulder function while you focus on recovery.
Understanding the process—general anesthesia combined with an interscalene or supraclavicular nerve block, and whether you’ll recover outpatient or inpatient— hopefully restores your feeling of control over your body. Your anesthesia team is here to support you every step of the way, ensuring a safe and comfortable experience as you begin your journey to a stronger, pain-free shoulder.
Feel free to re-read this article leading up to your surgery day. Close your eyes and visualize the process and practice observing what is happening and appreciating the expertise of those whose purpose lies in caring only for you.
If you have more questions or want to learn about anesthesia for other procedures, explore this website, reach out, or talk to your healthcare team. I'm here to help you feel prepared and at ease. Prepared patients have better outcomes.
Want to learn more about the actual experience of general anesthesia? Click the photo for a link to General Anesthesia: The Patient Experience from Start to Finish:
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Questions still unanswered? Click on the logo below to read more Articles about anesthesia, or email Jen from the Worry-Free Anesthesia home page!
**Information provided is intended as general healthcare information for the public and should be used as a guide. This information should not be substituted for the specific personal advice recommended by your own healthcare team who are familiar with your specific health history.*