K C Khanduri1. 1. Senior Advisor (Anaesthesiology), Military Hospital, Jabalpur.
Abstract
BACKGROUND: In recent years, there has been a significant resurgence of interest in regional anaesthesia techniques. Despite various advantages, regional anaesthesia is not used to its full potential in orthopaedic surgeries. METHODS: This study was conducted to evaluate the efficacy and safety of regional anaesthesia techniques in 400 consecutive patients, posted for orthopaedic surgeries in a tertiary care centre. Data was analysed for patient profile, type of surgery, nature of anaesthetic technique used, success rate, complications and satisfaction level of patients. RESULT: Age of patients ranged from three months to 92 years with male preponderance (84.5 %). Regional anaesthesia was used in 85% cases. Most frequently used technique for upper limbs was supraclavicular brachial plexus block (12.05 %) followed by interscalene block (5.58 %) and intravenous regional anaesthesia or Bier's block (2.64 %). For lower limbs, subarachnoid block was used in 50 % cases followed by combined spinal-epidural technique (21.47 %) and paravertebral block (4.70 %). Less commonly used techniques like lumbar plexus block, popliteal fossa block, sciatic + femoral nerve blocks were found to be useful but incidence of partial blocks was high. Overall success rate was 96.17 %. In 22.05 % cases supplementation with analgesic / sedative was needed, whereas in 3.82 % cases, technique was converted into general anaesthesia. There was no major complication. Six patients had reversible sensory neuropathy. In 91.64 % cases, satisfaction level was good to excellent. CONCLUSION: Skilfully performed techniques in regional anaesthesia can facilitate excellent surgical anaesthesia and postoperative pain management.
BACKGROUND: In recent years, there has been a significant resurgence of interest in regional anaesthesia techniques. Despite various advantages, regional anaesthesia is not used to its full potential in orthopaedic surgeries. METHODS: This study was conducted to evaluate the efficacy and safety of regional anaesthesia techniques in 400 consecutive patients, posted for orthopaedic surgeries in a tertiary care centre. Data was analysed for patient profile, type of surgery, nature of anaesthetic technique used, success rate, complications and satisfaction level of patients. RESULT: Age of patients ranged from three months to 92 years with male preponderance (84.5 %). Regional anaesthesia was used in 85% cases. Most frequently used technique for upper limbs was supraclavicular brachial plexus block (12.05 %) followed by interscalene block (5.58 %) and intravenous regional anaesthesia or Bier's block (2.64 %). For lower limbs, subarachnoid block was used in 50 % cases followed by combined spinal-epidural technique (21.47 %) and paravertebral block (4.70 %). Less commonly used techniques like lumbar plexus block, popliteal fossa block, sciatic + femoral nerve blocks were found to be useful but incidence of partial blocks was high. Overall success rate was 96.17 %. In 22.05 % cases supplementation with analgesic / sedative was needed, whereas in 3.82 % cases, technique was converted into general anaesthesia. There was no major complication. Six patients had reversible sensory neuropathy. In 91.64 % cases, satisfaction level was good to excellent. CONCLUSION: Skilfully performed techniques in regional anaesthesia can facilitate excellent surgical anaesthesia and postoperative pain management.
Authors: R Fuzier; B Tissot; V Mercier-Fuzier; C Barbero; D Caussade; F Mengelle; E Villacèque; C Virenque; K Samii; J L Ducassé Journal: Ann Fr Anesth Reanim Date: 2002-03
Authors: Chester C Buckenmaier; Geselle M McKnight; James V Winkley; Lisa L Bleckner; Clarence Shannon; Stephen M Klein; Robert C Lyons; John H Chiles Journal: Reg Anesth Pain Med Date: 2005 Mar-Apr Impact factor: 6.288