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Regional nerve blocks for hand surgery benefit patients and hospital
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MADRID — The use of regional nerve block anesthesia for hand surgery has benefits for both the patient and the hospital, one physician has said.
Mark Swindells, MA, MBBChir, presented his findings at the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Congress 2010, here.
“Regional anesthesia has potential benefits and problems,” Swindells said. “It is generally safe and effective, and possibly cheaper … there is less morbidity for the patient, as well.”
He added, however, that regional anesthesia coverage can be “patchy,” and that physicians may not want the patient to be awake or possibly tense.
Reporting on activity
The purpose of his team’s investigation was to report the related activity in a tertiary hand surgery unit through the course of 1 year.
Swindells’s department performed a total of 3,335 cases of hand surgery between August 2008 and August 2009. Of these, he said, 1,791 had a regional block. Ages were varied, with patients aged anywhere from 13 years to 92 years: mean of 47 years.
Surgeons performing the procedures also varied, with 1,011 performed by a consultant anesthetist, 266 performed by a trainee an 472 by non-career grade professionals. Six hundred and forty-six of the procedures were for trauma surgery, with 1,145 were performed as elective surgery and 87 were arthroscopic.
“We found that there is better pain control,” Swindells said. “The block wears off slowly, and you can dovetail in oral analgesia … it may be cheaper, it is safe and we do not need a specialist recovery ward.”
“A vast range of surgery”
Swindells said that a vast range of surgery was safely performed under the regional block, with no significant complications. All regional nerve blocks, he added, were performed with the aid of ultrasound.
Furthermore, the use of regional nerve blocks aided in the training of junior anesthetists. Patients also required very little time to recover from a regional nerve block – as compared to general anesthesia – meaning resource requirements are lower.
- Reference:
Swindells, M, Chennagiri R, Cresswell T. Regional anaesthesia in a tertiary hand unit: 1,791 cases over 1 year. Paper F624. Presented at the EFORT Congress 2010. June 2-5, 2010. Madrid, Spain.
