Brachial Plexus Block for Upper Limb Procedures: Experience at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria

Abstract

Background: Brachial plexus block (BPB) has many benefits over general anaesthesia in upper limb procedures. However, its utilization in Nigeria is not as high as expected. Aims: To evaluate BPB in upper limb surgeries, its utilization, outcome and complication profile. Materials and Methods: Approval for the study was obtained from the institution's research ethical committee. This was a retrospective study of all patients who underwent upper limb surgeries from May 2011 to December 2014. Those who had BPB were further analysed. Data was obtained from the anaesthesia register and records, as well as the patients‘ folders. Information obtained included: age, gender, ASA class, type of BPB and nerve localization technique. The primary outcome was the adequacy of the block for surgery and complications. Data analysis was done using SPSS, version 16. Results: Ninety two patients underwent upper limb surgeries, out of which 42(4S.65%) were performed under BPB, the rest were done under GA-45(48.91%), local infiltration-4(4.35%) or wrist block-1(1.09%). Combined interscalene and axillary blocks were performed in 35(83.3%) patients, interscalene block only-5(11.9%), combined interscalene and supraclavicular blocks, and axillary block only in 1(2.4%) patient each. Paraesthesia technique-40(95.2%) was the dominant nerve localization technique, while nerve stimulator was used in 2(4.8%) patients only. BPB was adequate in 37(88.1%) patients, while it failed in only 5(11.9%) patients, and were converted to GA. No major complication was observed except dysthesia reported in 1(2.4%) patient postoperatively. Conclusion: The use of brachial plexus block for upper limb procedure in our centre is rising. Paraesthesia technique is predominant, and it is associated with a high success rate and low complications.