Nerve Block, Postoperative Complications, Regional Anesthesia
Conditions
Keywords
Regional Anesthesia, Postoperative neurological complications, Ultrasound, Nerve stimulator, Brachial Plexus Block
Brief summary
Locorregional anaesthesia have been increased its role in different kind of surgeries, alone or combined with general anesthesia. Due to ultrasound, peripheral nerve blocks have been increased their importance in locoregional anaesthesia. They provide excellent intraoperative and postoperative analgesia, decreasing the need for intravenous opioids which increase postoperative nausea and vomiting which may prolong hospital stay. The primary study objective is to analyze retrospectively the use of peripheral nerve blocks in the current practice of a specialized regional anaesthesia division. This is an observational, retrospective and unicenter study. 1346 patients scheduled for the surgery needed a peripheral nerve block were enrolled.
Detailed description
Locorregional anaesthesia have been increased its role in different kind of surgeries, alone or combined with general anesthesia. Due to ultrasound, peripheral nerve blocks have been increased their importance in locoregional anaesthesia. They provide excellent intraoperative and postoperative analgesia, decreasing the need for intravenous opioids which increase postoperative nausea and vomiting which may prolong hospital stay. However, peripheral nerve blocks may be associated with postoperative complications, especially neurological ones. Classically, interscalene brachial plexus block produced a 100% incidence of phrenic nerve paralysis with resultant pulmonary compromise. Little literature has published a following of complications. The primary study objective is to analyze retrospectively the use of peripheral nerve blocks in the current practice of a specialized regional anaesthesia division. The secondary objectives are assessed the patients characteristics of our sample, local anaesthetic dose used, the peripheral nerve block operator, the nerve location technique, the surgery and the complication rate after peripheral nerve block. This is an observational, retrospective and unicenter study. 1346 patients scheduled for the surgery needed a peripheral nerve block were enrolled.
Interventions
PROCEDUREPeripheral nerve block
Peripheral nerve block consists of the administration of a local anaesthetic into the nerves to inhibit nerve transmission in a specific part of the body. Ultrasound or Nerve stimulator could be used to locate the peripheral nerve. A needle is placed through the anatomical references to administer local anaesthetic around the peripheral nerve. Single-shot or continuous blocks are performed preoperatively and postoperatively as current practice in the surgery theatre. Using ultrasound, in-plane or out-plane approach could be performed. Peripheral nerve block provides excellent intraoperative and postoperative analgesia decreasing the need for intravenous pain drugs. Interscalene block, supraclavicular block, safene block, femoral block, BRILMA block are different kinds of peripheral nerve block using in the anaesthestic current practice.
Sponsors
Hospital Miguel Servet
Instituto de Investigación Sanitaria Aragón
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Every patient who needs a peripheral nerve block performed by Anestesia Department.
Exclusion criteria
* Patient refusal of peripheral nerve block. * Known allergy to amide local anaesthetic drugs * Absolute contraindications to perform a peripheral nerve block as coagulopathy, active infection at the block site or severe respiratory background.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Peripheral nerve block | During procedure | This primary outcome is the type of peripheral nerve block performed |
| Incidence and frequency of Serious Adverse Events (SAE) | From performing the peripheral nerve block to 1-year follow-up | This primary outcome is the incidence, frequency and severity of Serious Adverse Events (SAE) as assessed by CTCAE v4.0 after peripheral nerve block. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Local anesthetic dose used in peripheral nerve block | During procedure | Local anesthetic dose (mg) used in peripheral nerve block performance |
| Local anesthetic volume used in peripheral nerve block | During procedure | Local anesthetic volume (ml) used in peripheral nerve block performance |
| Incidence and frequency of Postoperative neurological complications (PONC) | From performing the peripheral nerve block to 1-year follow-up | This secondary outcome is the incidence, frequency and severity of Postoperative neurological complications (PONC) as assessed by CTCAE v4.0 after peripheral nerve block. |
| Peripheral nerve block operator | During procedure | Anesthesiologist operator of peripheral nerve block (attending or trainee). |
| Nerve location technique used in peripheral nerve block | During procedure | Type of nerve location technique (ultrasound, nerve stimulator or paresthesia techinique) used in peripheral nerve block performance |
| Local anesthetic used in peripheral nerve block | During procedure | Local anesthetic type (FDA drug) used in peripheral nerve block performance |
Countries
Spain
Outcome results
None listed