1- Interno de Anestesiologia, Centro Hospitalar de Lisboa Central
2- Interno de Anestesiologia, Centro Hospitalar de Vila Nova de Gaia
3- Assistente Hospitalar Graduado, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central
4- Chefe de Serviço, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central
- Reunião Internacional 33 Annual ESRA Congress 2014 - Sevilha
- Poster
Resumo:
Background and aims: Regional analgesia techniques are popular as the sole technique for surgery, for combined analgesia and for post-operative and/or chronic pain management, as the effects tend to be limited to a desired part of the body, and after-effects are usually less than after general anesthesia. Furthermore, ultrasound guidance has become a daily tool in the performance of many of these blocks. To better know what we do concerning lower extremity blocks, and considering that our hospital is a teaching and pediatric hospital, we performed this retrospective study.
Methods: Retrospective study of the lower extremity blocks at the Dona Estefânia Hospital, Lisbon, Portugal, between 2012 and 2013, with regard to block, age, ASA score, surgical intervention, use of neurostimulator or ultrasound guidance and catheter placing.
Results: We retrieved 169 lower extremity blocks during the time frame, results as follows.
|
Total |
Age |
Neurostimulator |
Ultrasonography |
Catheter placement |
||||||||
|
Block |
<27 days |
1m - 1y |
1-10y |
>10y |
total |
% |
total |
% |
Total |
% |
||
|
Ankle |
17 |
10,1% |
6 |
11 |
15 |
88,2% |
2 |
11,8% |
0,0% |
|||
|
Sciatic (Anterior) |
6 |
3,6% |
2 |
4 |
0,0% |
6 |
100,0% |
0,0% |
||||
|
Sciatic (Popliteal) |
58 |
34,3% |
18 |
40 |
4 |
6,9% |
56 |
96,6% |
11 |
19,0% |
||
|
Sciatic (Subgluteal) |
2 |
1,2% |
1 |
1 |
0,0% |
2 |
100,0% |
1 |
50,0% |
|||
|
Femoral cutaneous n. |
11 |
6,5% |
4 |
7 |
0,0% |
11 |
100,0% |
1 |
9,1% |
|||
|
Femural |
59 |
34,9% |
1 |
15 |
43 |
3 |
5,1% |
58 |
98,3% |
12 |
20,3% |
|
|
Obturator |
8 |
4,7% |
2 |
6 |
0,0% |
8 |
100,0% |
0,0% |
||||
|
Peroneal |
1 |
0,6% |
1 |
0,0% |
1 |
100,0% |
0,0% |
|||||
|
Peroneal Sup. + Deep. |
2 |
1,2% |
2 |
1 |
50,0% |
1 |
50,0% |
0,0% |
||||
|
Lumbar plexos |
1 |
0,6% |
1 |
0,0% |
1 |
100,0% |
0,0% |
|||||
|
Saphenous |
2 |
1,2% |
2 |
0,0% |
2 |
100,0% |
0,0% |
|||||
|
Tibial |
2 |
1,2% |
2 |
0,0% |
2 |
100,0% |
0,0% |
|||||
|
Totals |
169 |
100,0% |
0 |
1 |
49 |
119 |
23 |
150 |
25 |
|||
Conclusion: As our hospital is a teaching and pediatrics center, the number of performed blocks seems to be adequate for a correct learning curve for residents and specialists as well in this area, although there is not enough data in the literature to compare to. The lack of data concerning complications and 7 day follow-up indicates a need for improvement in data registry, and limits the study’s adequateness. A broader study might ensue from this retrospective analysis, allowing for a better registry and knowledge of what we do.
Palavras Chave: Lower limb, Blocks, Regional Anesthesia