scholarly journals Patient satisfaction with intravenous regional anaesthesia or an axillary block for minor ambulatory hand surgery

2020 ◽  
Vol 37 (10) ◽  
pp. 847-856
Author(s):  
An Teunkens ◽  
Kristien Vermeulen ◽  
Ann Belmans ◽  
Ilse Degreef ◽  
Marc Van de Velde ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Regional Anaesthesia ◽  
Hand Surgery ◽  
Axillary Block ◽  
Intravenous Regional Anaesthesia

scholarly journals Efficacy of ultrasound-guided forearm nerve block versus forearm intravenous regional anaesthesia in patients undergoing carpal tunnel release: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246863
Author(s):  
Hassanin Jalil ◽  
Florence Polfliet ◽  
Kristof Nijs ◽  
Liesbeth Bruckers ◽  
Gerrit De Wachter ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Intensity ◽  
Nerve Block ◽  
Carpal Tunnel ◽  
Regional Anaesthesia ◽  
Carpal Tunnel Release ◽  
Ultrasound Guided ◽  
Surgical Time ◽  
Randomized Controlled ◽  
Intravenous Regional Anaesthesia

Background and objectives Distal upper extremity surgery is commonly performed under regional anaesthesia, including intravenous regional anaesthesia (IVRA) and ultrasound-guided forearm nerve block. This study aimed to investigate if ultrasound-guided forearm nerve block is superior to forearm IVRA in producing a surgical block in patients undergoing carpal tunnel release. Methods In this observer-blinded, randomized controlled superiority trial, 100 patients undergoing carpal tunnel release were randomized to receive ultrasound-guided forearm nerve block (n = 50) or forearm IVRA (n = 50). The primary outcome was anaesthetic efficacy evaluated by classifying the blocks as complete vs incomplete. Complete anaesthesia was defined as total sensory block, incomplete anaesthesia as mild pain requiring more analgesics or need of general anaesthesia. Pain intensity on a numeric rating scale (0–10) was recorded. Surgeon satisfaction with hemostasis, surgical time, and OR stay time were recorded. Patient satisfaction with the quality of the block was assessed at POD 1. Results In total, 43 (86%) of the forearm nerve blocks were evaluated as complete, compared to 33 (66%) of the forearm IVRA (p = 0.019). After the forearm nerve block, pain intensity was lower at discharge (-1.76 points lower, 95% CI (-2.92, -0.59), p = 0.0006) compared to patients treated with forearm IVRA. No differences in pain experienced at the start of the surgery, during surgery, and at POD1, nor in surgical time or total OR stay were observed between groups. Surgeon (p = 0.0016) and patient satisfaction (p = 0.0023) were slightly higher after forearm nerve block. Conclusion An ultrasound-guided forearm nerve block is superior compared to forearm IVRA in providing a surgical block in patients undergoing carpal tunnel release. Trial registration This trial was registered as NCT03411551.

The Use of Bier's Block for Day Case Surgery

1995 ◽  
Vol 20 (5) ◽  
pp. 679-680 ◽  
Author(s):  
D. J. DUNLOP ◽  
C. M. GRAHAM ◽  
M. A. WALDRAM ◽  
P. J. MULLIGAN ◽  
J. M. WATT
Keyword(s):  
Success Rate ◽  
Regional Anaesthesia ◽  
Hand Surgery ◽  
Large Series ◽  
Day Case ◽  
Day Case Surgery ◽  
Minimal Morbidity ◽  
Case Surgery ◽  
Intravenous Regional Anaesthesia

With the increasing popularity of day case surgery it is important to ensure that safe and appropriate techniques are being used. We retrospectively reviewed a large series of 732 patients who underwent planned day case hand surgery under intravenous regional anaesthesia (modified Bier's block) over a 5-year period. We found a modified Bier's block to be ideally suited to day case surgery with no deaths, minimal morbidity and a success rate in excess of 98%.

A Modification of the Technique for Intravenous Regional Blockade for Hand Surgery

2000 ◽  
Vol 25 (6) ◽  
pp. 575-577 ◽  
Author(s):  
C. H. J. THAM ◽  
B. H. LIM
Keyword(s):  
Prospective Study ◽  
Regional Anaesthesia ◽  
Hand Surgery ◽  
Subjective Assessment ◽  
Distal Forearm ◽  
Operating Field ◽  
Experienced Pain ◽  
Intravenous Regional Anaesthesia ◽  
A Prospective Study

A prospective study was conducted to assess a modification to Bier’s intravenous regional anaesthesia which introduced a third temporary distal forearm tourniquet. This confines the injected lignocaine to the hand, resulting in a higher local lignocaine concentration. Subsequent exsanguination of the limb then channels the remaining intravascular lignocaine under the distal cuff of a double tourniquet. Of the 18 patients, none experienced pain during operation and all tolerated the tourniquet without significant discomfort. Mild postoperative giddiness was noted in one patient. No other anaesthetic complications were encountered. In a subjective assessment of the bloodlessness of the operating field, two were ranked satisfactory, ten good and six excellent. None of the patients required re-exsanguination when using this technique.

Intravenous Regional Anaesthesia in Hand Surgery — Experience with 632 Cases

HAND ◽  
1981 ◽  
Vol os-13 (2) ◽  
pp. 192-198 ◽  
Author(s):  
K. M. Chan ◽  
G. F. Y. Ma ◽  
Y. N. Chow ◽  
P. C. Leung
Keyword(s):  
Regional Anaesthesia ◽  
Orthopaedic Surgery ◽  
Hand Surgery ◽  
Practical Experience ◽  
Patient Comfort ◽  
Intravenous Regional Anaesthesia

Practical experience in the use of intravenous regional anaesthesia in hand surgery on 632 patients is reported. The safety of the anaesthesia, the efficacy of the procedure and the patient-comfort are well attested in this study. We recommend that its role should be established particularly in busy orthopaedic surgery departments where both elective and emergency work-loads on hand surgery are heavy.

scholarly journals 907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Crotty ◽  
M Corbett ◽  
T Hussain ◽  
A Diaconescu ◽  
N Patil
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Effective Alternative ◽  
General Anaesthetic ◽  
Single Centre ◽  
Pain Scores ◽  
Single Centre Experience ◽  
Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

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