A Comparison of Infraclavicular Nerve Block versus  General Anesthesia for Hand and Wrist Day-case Surgeries

Abstract

Infraclavicular brachial plexus block with a short-acting local anesthetic was associated with time-efficient anesthesia, faster recovery, fewer adverse events, better analgesia, and greater patient acceptance than GA followed by wound infiltration with a local anesthetic in outpatients undergoing hand and wrist surgery.

Les facteurs influençant la récupération et la sortie après une opération en chirurgie ambulatoire

“…Patients in the nerve block group achieved PACU bypass criteria more quickly, had less pain and nausea, and were discharged home faster than patients in the GA group. 45 Similar findings were observed in patients having knee arthroscopy, hand surgery and rotator cuff surgery. [46][47][48] Interscalene blocks can provide good analgesia after shoulder surgery, shorten recovery time, and are associated with less nausea and vomiting and a lower rate of unanticipated hospital admissions compared with GA. 49,50 A suprascapular block can improve recovery profiles and facilitate early discharge after arthroscopic shoulder surgery.…”

A “swing room” model based on regional anesthesia reduces turnover time and increases case throughput

“…However, consistent with our experience and the results of others is the finding that these regional anesthesia techniques are associated with high degrees of patient satisfaction and are safe. 2,3,16 At present, we are planning to develop a comprehensive regional anesthesia database for our centre that would include this type of data.…”

“…Dans le groupe SOR-AR, des antie´me´tiques postope´ratoires ont e´teá dministre´s à 3/164 patients (2 %) vs 28/164 (17 %) dans le groupe SO-AG (P \ 0,0001), et des opioı¨des ont e´teá dministre´s à 1/164 (0,6 %) vs 132/164 (80 %) patients, respectivement (P \ 0,0001). Le nombre moyen de cas re´alisables dans une journe´e e´tait 56 % plus e´leve´dans le groupe SOR-AR que dans le groupe SO-AG (8,4 [7,[5][6][7][8][9]4] vs 5,4 [5,[1][2][3][4][5]8], respectivement; P \ 0,0001). Conclusion Par rapport a`un mode`le conventionnel ayant recours a`l'anesthe´sie ge´ne´rale dans une seule salle d'ope´ration, la mise en oeuvre d'un mode`le utilisant l'anesthe´sie re´gionale dans deux salles d'ope´ration en rotation a e´te´associe´e à une re´duction du temps ne´cessaire entre les cas, de meilleurs profils de re´cupe´ration et un volume plus e´leve´de cas traite´s.…”

“…[1][2][3][4][5][6][7] For these reasons, our centre, a tertiary care teaching hospital in Vancouver, British Columbia, has recently developed, implemented, and transitioned to a novel perioperative ambulatory care model focused on regional anesthesia for both upper and lower extremity surgery. The conception of this new care model by a multidisciplinary team, which includes anesthesiologists, surgeons, nurses, anesthesia assistants, and hospital administrators, led to the opening of the ''Outpatient Department Surgical Procedure Rooms'' in 2009.…”

Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain

“…The first such use involved cocaine administration during eye surgery in 1884, and, although effective, cocaine was associated with considerable toxicities that prompted subsequent development of safer alternatives ( Figure 1) [1,2]. Today, local or regional administration of anesthetics is integral to prevention of perioperative pain [3][4][5][6][7][8]. Ropivacaine, chloroprocaine, lidocaine, mepivacaine and bupivacaine are administered perioperatively via infiltration, peripheral or epidural (i.e., neuraxial) nerve block [9,10].…”