Incidence of Failure of Continuous Peripheral Nerve Catheters for Postoperative Analgesia in Upper Extremity Surgery

Ahsan, Zahab S.; Carvalho, Brendan; Yao, Jeffrey

doi:10.1016/j.jhsa.2013.11.011

Cited by 58 publications

(33 citation statements)

References 28 publications

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“…Ketorolac could have been added to the infiltration solution, as studies have shown this to be beneficial [27,28], but reports of NSAIDs impairing tendonto-bone healing (in animal studies [29]) limited this option, as our surgical access involved reinsertion of the subscapularis tendon. We had also expected better results for the ISC group; however, we found a high failure rate compared to the literature [30]. This may be due to the many anaesthesiologists involved at Horsens Regional Hospital, each with a smaller case exposure, since the technique is known to require a high level of training and experience, and our practice has since changed to accommodate this to a greater extent.…”

Section: Discussionmentioning

confidence: 69%

Local infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial

Bjørnholdt

Jensen

Bendtsen

et al. 2015

Eur J Orthop Surg Traumatol

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Section: Discussionmentioning

confidence: 69%

Local infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial

Bjørnholdt

Jensen

Bendtsen

et al. 2015

Eur J Orthop Surg Traumatol

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“…Ullah et al in their Cochrane review found better pain relief for continuous interscalene brachial block compared to parenteral analgesia (33). Failure rates can be low (0.4%) (34) or extremely high (18.8%) (35). Potential complications after interscalene catheter insertion are hoarseness, neurologic sequelae, dyspnea, and nerve injury; the reported incidence ranges from 0.8% long-term neurologic deficits to 31% hoarseness (36,37).…”

Section: Efficacy and Complicationsmentioning

confidence: 99%

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Suksompong

Bormann

2020

Anesth Pain Med

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Context: Perioperative analgesia is an essential but frequently underrated component of medical care. The purpose of this work is to describe the actual situation of surgical patients focusing on effective pain control by discarding prejudice against 'aggressive' measures. Evidence Acquisition: This is a narrative review about continuous regional pain therapy with catheters in the postoperative period. Included are the most-relevant literature as well as own experiences. Results: As evidenced by an abundance of studies, continuous regional/neuraxial blocks are the most effective approach for relief of severe postoperative pain. Catheters have to be placed in adequate anatomical positions and meticulously maintained as long as they remain in situ. Peripheral catheters in interscalene, femoral, and sciatic positions are effective in patients with surgery of upper and lower limbs. Epidural catheters are effective in abdominal and thoracic surgery, birth pain, and artery occlusive disease, whereas paravertebral analgesia may be beneficial in patients with unilateral approach of the truncus. However, failure rates are high, especially for epidural catheter analgesia. Unfortunately, many reports lack a comprehensive description of catheter application, management, failure rates and complications and thus cannot be compared with each other. Conclusions: Effective control of postoperative pain is possible by the application of regional/neuraxial catheters, measures requiring dedication, skill, effort, and funds. Standard operating procedures contribute to minimizing complications and adverse side effects. Nevertheless, these methods are still not widely accepted by therapists, although more than 50% of postoperative patients suffer from 'moderate, severe or worst' pain.

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“…Various complications including block insufficiency due to CBPB, local infections, heart attack, hematoma, pleural effusion, paresthesia, and drug toxicity have been reported. 11,23,24 Bupivacaine peripheral nerve blocks are used in various operations including spinal and epidural anesthesia. It is a highly preferred local anesthetic for acceptable start times, longer duration of activity (3-16 hours), and its ability for making dose-dependent sensory and motor block individually.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Single-Dose Infraclavicular Brachial Plexus Block and Continuous Infraclavicular Brachial Plexus Block Applications in the Treatment of Finger Amputations

Şahin

Çakmak

Birtay

2019

Journal of Hand and Microsurgery

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Introduction The aim of this study is to evaluate the replantation success of single-dose infraclavicular brachial plexus block and continuous infraclavicular brachial plexus block (CIBPB) applied with bupivacaine and prilocaine in patients with finger amputation. Materials and Methods This prospective randomized nonblinded study was conducted between January 2012 and September 2017, and 47 patients, all male, were included. Patients were randomly separated into two groups as 23 patients CIBPB applied group (group A) and 24 patients single-dose infraclavicular block applied group (group B). In group B, after the effect of block is ceased, intravenous patient-controlled (PC) opioid analgesia and, where necessary, 1 mg/kg meperidine and 75 mg diclofenac sodium intramuscularly were alternately administered at 4 to 6 hours intervals. The average ages were 30.7 ± 10.06 and 29 ± 9.08, respectively. Replantations were applied as being two venous anastomoses to one artery, where possible. Hourly skin temperatures of fingers of the hands in which both surgeries applied and no surgery applied in both the groups were measured for 3 days with an infrared thermometer. Also, Numerical Rating Scale (NRS) evaluations in both the groups were performed in 3-hour intervals for 3 days. Results Replantations were successful in 22 patients in whom CIBPB was applied (95.6%) and in 19 patients in whom single block was applied (79.16%). Regarding the finger temperatures, no significant difference was detected between both the groups for 3 days following the operation. No significant difference was found between the length of hospital stays (4.73 ± 2.21—4.71 ± 1.53) and duration of operations (2.90 ± 0.73—2.83 ± 0.58). There was no significant difference between the temperature values of both the groups. NRS scores of group A were statistically significantly lower than those of group B. Conclusion In this prospective randomized study performed by using bupivacaine and prilocaine on 24 patients, the success rate of finger replantations with CIBPB was found to be higher. CIBPB is a very beneficial method that should be taken in consideration in hand injuries with anastomosis and high risk of vasospasm. Further studies with more number of cases would help reduce the question marks related with the success of this method.

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Incidence of Failure of Continuous Peripheral Nerve Catheters for Postoperative Analgesia in Upper Extremity Surgery

Cited by 58 publications

References 28 publications

Local infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial

Local infiltration analgesia versus continuous interscalene brachial plexus block for shoulder replacement pain: a randomized clinical trial

Regional Catheters for Postoperative Pain Control: Review and Observational Data

Comparison of Single-Dose Infraclavicular Brachial Plexus Block and Continuous Infraclavicular Brachial Plexus Block Applications in the Treatment of Finger Amputations

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