학술논문
Evaluation of the Incidence of Paresthesia in Patients Having Upper Extremity Surgery and being Performed Peripheral Nerve Block/Ust Ekstremite Cerrahisi Geciren ve Periferik Sinir Blogu Uygulanan Hastalarda Parestezi Insidansinin Degerlendirilmesi
ARASTIRMA MAKALESI/RESEARCH ARTICLE: CERRAHI TIP BILIMLERI/SURGICAL SCIENCES
ARASTIRMA MAKALESI/RESEARCH ARTICLE: CERRAHI TIP BILIMLERI/SURGICAL SCIENCES
Document Type
Academic Journal
Source
Journal of Ankara University Faculty of Medicine. July-Sep 2022, Vol. 75 Issue 3, p335, 7 p.
Subject
Language
English
Abstract
Giris Periferik sinir bloklari pek cok cerrahi prosedurde etkin anestezi ve sistemik opioidlerden daha etkin analjezik etki saglamasi ve ultrasonografi kullaniminin yayginlasmasi nedeniyle son yillarda daha cok uygulanmaktadir. Bununla birlikte [...]
Objectives: With the widespread use of ultrasonography, peripheral nerve blocks are used as an effective anesthesia technique in most surgical procedures. We aimed to evaluate the incidence of paresthesia in brachial plexus blockade performed at different levels. Materials and Methods: Patients who underwent peripheral nerve block for upper extremity surgery in Ibni Sina Hospital Orthopedics Operating Room were included in this study. Demographic data of the patients, type and duration of operation, type of brachial plexus block, local anesthetic dose, sedation and additional anesthetic requirement were recorded from patients' files. The presence of sensory or motor deficits lasting more than 6 months in the postoperative period was defined as prolonged paresthesia. Results: Our study included 205 patients who underwent upper extremity surgery. Of these patients, 50% (n=102) had hand surgery, 25% (n=51) had forearm surgery, and 25% (n=51) had shoulder surgery. Supraclavicular blockade was performed in 44.4% (n=91), axillary blockade in 29.8% (n=61), and interscalene blockade in 25.6% (n=53). The mean age of the patients was 44.44[+ or -]16.73 years. 52.2% (n=107) were male and 47.8% (n=98) were female. The incidence of paresthesia was 36.1% (n=74). Among the patients, 30.2% (n=62) reported numbness, 25.4% (n=52) reported tingling, 4.4% (n=9) reported abnormal sensation, 16.6% (n=34) reported pain, and 23.9% reported weakness. There was no statistically significant difference between patients with and without paresthesia in terms of demographic data, type of blockade, sedation, duration of surgery, and amount of local anesthesia (p>0.05). 52.7% (n=39) of patients had paresthesia for 6 months or less, 47.3% (n=35) had paresthesia longer than 6 months. Although not statistically significant, paresthesia lasting longer than 6 months was more common in the supraclavicular blockade group (p>0.05). Conclusion: The incidence of paresthesia is high in upper extremity peripheral nerve block and many undetermined risk factors may be effective. Therefore, a detailed preoperative evaluation should be performed when selecting patients. Key Words: Paresthesia, Upper Extremity, Brachial Plexus, Nerve Blockade Amac: Ultrasonografi kullaniminin yayginlasmasi ile periferik sinir bloklari cogu cerrahi prosedurde etkin bir anestezi teknigi olarak kullanilmaktadir. Bu calismada farkli seviyelerde gerceklestirilen brakiyal pleksus blokaji uygulamalarindaki (supraklavikuler, aksiller ve interskalen) parestezi insidansinin degerlendirilmesi amaclandi. Gerec ve Yontem: Ibni Sina Flastanesi Ortopedi Ameliyathanesi'nde ust ekstremite cerrahisi icin periferik sinir blogu yapilan hastalar calismaya dahil edildi. Hastalarin demografik verileri, operasyon tipi ve suresi, brakiyal pleksus blogu tipi, lokal anestezik dozu, sedasyon ve ek anestezi gereksinimleri hasta kayitlarindan kaydedildi. Postoperatif donemde 6 aydan uzun suren duyusal veya motor defisit varligi uzamis parestezi olarak tanimlandi. Bulgular: Calismamiza ust ekstremite cerrahisi geciren 205 hasta dahil edildi. Bu hastalarin %50'si (n= 102) el cerrahisi, %25'i (n=51) on kol ve %25'i (n=51) omuz cerrahisi gecirmislerdi. Hastalarin %44,4'une (n=91) supraklavikuler blokaj, %29,8'ine (n=61) aksiller blokaj ve %25,6'sina (n=53) interskalen blokaj uygulanmisti. Hastalarin yas ortalamasi 44,44[+ or -]16,73 idi. %52,2'si (n=107) erkek, %47,8'i (n=98) kadindi. Parestezi insidansi %36,1 (n=74) idi. Hastalarin %30,2'si (n=62) uyusukluk, %25,4'u (n=52) karincalanma, %4,4'u (n=9) normal olmayan his, %16,6'si (n=34) agri ve %23,9'u gucsuzluk bildirdi. Parestezi gorulen ve gorulmeyen hastalar arasinda demografik veriler, uygulanan blokaj turu, sedasyon uygulanmasi, ameliyat suresi, lokal anestezi miktarlari yonunden istatistiksel olarak anlamli farklilik yoktu (p>0,05). Parestezisi olan hastalarin %52,7'sinde (n=39) 6 ay veya daha kisa sure parestezi, %47,3'unde (n=35) 6 aydan uzun sure parestezi vardi. Istatistiksel olarak anlamli olmasa da 6 aydan uzun suren parestezi supraklavikuler blok grubunda daha sikti (p>0,05). Sonuc: Ust ekstremite periferik sinir blogunda parestezi insidansi yuksektir ve belirlenmemis bircok risk faktoru etkili olabilir. Bu nedenle hasta secimi yapilirken detayli bir preoperatif degerlendirme yapilmalidir. Anahtar Kelimeler: Parestezi, Ust Ekstremite, Brakiyal Pleksus, Sinir Blokaji
Objectives: With the widespread use of ultrasonography, peripheral nerve blocks are used as an effective anesthesia technique in most surgical procedures. We aimed to evaluate the incidence of paresthesia in brachial plexus blockade performed at different levels. Materials and Methods: Patients who underwent peripheral nerve block for upper extremity surgery in Ibni Sina Hospital Orthopedics Operating Room were included in this study. Demographic data of the patients, type and duration of operation, type of brachial plexus block, local anesthetic dose, sedation and additional anesthetic requirement were recorded from patients' files. The presence of sensory or motor deficits lasting more than 6 months in the postoperative period was defined as prolonged paresthesia. Results: Our study included 205 patients who underwent upper extremity surgery. Of these patients, 50% (n=102) had hand surgery, 25% (n=51) had forearm surgery, and 25% (n=51) had shoulder surgery. Supraclavicular blockade was performed in 44.4% (n=91), axillary blockade in 29.8% (n=61), and interscalene blockade in 25.6% (n=53). The mean age of the patients was 44.44[+ or -]16.73 years. 52.2% (n=107) were male and 47.8% (n=98) were female. The incidence of paresthesia was 36.1% (n=74). Among the patients, 30.2% (n=62) reported numbness, 25.4% (n=52) reported tingling, 4.4% (n=9) reported abnormal sensation, 16.6% (n=34) reported pain, and 23.9% reported weakness. There was no statistically significant difference between patients with and without paresthesia in terms of demographic data, type of blockade, sedation, duration of surgery, and amount of local anesthesia (p>0.05). 52.7% (n=39) of patients had paresthesia for 6 months or less, 47.3% (n=35) had paresthesia longer than 6 months. Although not statistically significant, paresthesia lasting longer than 6 months was more common in the supraclavicular blockade group (p>0.05). Conclusion: The incidence of paresthesia is high in upper extremity peripheral nerve block and many undetermined risk factors may be effective. Therefore, a detailed preoperative evaluation should be performed when selecting patients. Key Words: Paresthesia, Upper Extremity, Brachial Plexus, Nerve Blockade Amac: Ultrasonografi kullaniminin yayginlasmasi ile periferik sinir bloklari cogu cerrahi prosedurde etkin bir anestezi teknigi olarak kullanilmaktadir. Bu calismada farkli seviyelerde gerceklestirilen brakiyal pleksus blokaji uygulamalarindaki (supraklavikuler, aksiller ve interskalen) parestezi insidansinin degerlendirilmesi amaclandi. Gerec ve Yontem: Ibni Sina Flastanesi Ortopedi Ameliyathanesi'nde ust ekstremite cerrahisi icin periferik sinir blogu yapilan hastalar calismaya dahil edildi. Hastalarin demografik verileri, operasyon tipi ve suresi, brakiyal pleksus blogu tipi, lokal anestezik dozu, sedasyon ve ek anestezi gereksinimleri hasta kayitlarindan kaydedildi. Postoperatif donemde 6 aydan uzun suren duyusal veya motor defisit varligi uzamis parestezi olarak tanimlandi. Bulgular: Calismamiza ust ekstremite cerrahisi geciren 205 hasta dahil edildi. Bu hastalarin %50'si (n= 102) el cerrahisi, %25'i (n=51) on kol ve %25'i (n=51) omuz cerrahisi gecirmislerdi. Hastalarin %44,4'une (n=91) supraklavikuler blokaj, %29,8'ine (n=61) aksiller blokaj ve %25,6'sina (n=53) interskalen blokaj uygulanmisti. Hastalarin yas ortalamasi 44,44[+ or -]16,73 idi. %52,2'si (n=107) erkek, %47,8'i (n=98) kadindi. Parestezi insidansi %36,1 (n=74) idi. Hastalarin %30,2'si (n=62) uyusukluk, %25,4'u (n=52) karincalanma, %4,4'u (n=9) normal olmayan his, %16,6'si (n=34) agri ve %23,9'u gucsuzluk bildirdi. Parestezi gorulen ve gorulmeyen hastalar arasinda demografik veriler, uygulanan blokaj turu, sedasyon uygulanmasi, ameliyat suresi, lokal anestezi miktarlari yonunden istatistiksel olarak anlamli farklilik yoktu (p>0,05). Parestezisi olan hastalarin %52,7'sinde (n=39) 6 ay veya daha kisa sure parestezi, %47,3'unde (n=35) 6 aydan uzun sure parestezi vardi. Istatistiksel olarak anlamli olmasa da 6 aydan uzun suren parestezi supraklavikuler blok grubunda daha sikti (p>0,05). Sonuc: Ust ekstremite periferik sinir blogunda parestezi insidansi yuksektir ve belirlenmemis bircok risk faktoru etkili olabilir. Bu nedenle hasta secimi yapilirken detayli bir preoperatif degerlendirme yapilmalidir. Anahtar Kelimeler: Parestezi, Ust Ekstremite, Brakiyal Pleksus, Sinir Blokaji