Pattern of Nerve Blocks for Upper Limb Surgery at the University of Benin Teaching Hospital - A Ten Year Survey

Abstract

Background: Central and peripheral neural blockade techniques are popular for lower and upper limb surgeries respectively. Lower limb surgery is amenable to central neural blockade techniques, anatomical and physiological imperatives makes peripheral neural blockade more suited for upper limb surgeries. We looked at the utilization of this latter technique in our centre, over a 10-year period.

Methods: Anaesthetic and the operating theatre medical records of patients who had upper limb surgery were retrieved. Information about patient demographic characteristics, surgical indication, type of anaesthesia and peripheral blockade were obtained. The data were analyzed and presented as simple nominal and frequency valves and tables.

Results: Over the 10–year review period, 269 upper limb surgeries were done, whereby, 239(89%) were under general anaesthesia and 30 (11%) were with peripheral neural blockade. Axillary brachial plexus block accounted for 27 (90%) of the peripheral blocks, while 2 patients (6.7%) had wrist block and 1 patient (3.3%) had elbow block.

Conclusion: The study showed low utilization of peripheral neural block techniques for upper limb surgeries over the review period. Upper limb neural blockades are easily performed with the aid of nerve stimulators and ultrasound-guided technique. Greater use should be made of them to avoid the risk of general anaesthesia and promote better postoperative pain management.

Key words: upper limb surgery, peripheral neural blockade