The Relevance of Regional Anesthesia in Orthopaedic Surgery: Advantages, disadvantages and challenges.

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Publicado: dic 1, 2018
DOI: https://doi.org/10.32457/ijmss.2018.040

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Obalum, D., & Ibeanusi, S. (2018). The Relevance of Regional Anesthesia in Orthopaedic Surgery: Advantages, disadvantages and challenges. International Journal of Medical and Surgical Sciences, 5(4), 164–170. https://doi.org/10.32457/ijmss.2018.040
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Vol. 5 Núm. 4 (2018): December 2018
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Revisión

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The Relevance of Regional Anesthesia in Orthopaedic Surgery: Advantages, disadvantages and challenges.

Contenido principal del artículo

Dike Obalum
Department of Surgery, State House Medical Centre Abuja.
Sidney Ibeanusi
Department of Surgery, University of Port Harcourt Teaching Hospital Port Harcourt.

Resumen

The relevance of regional anaesthesia in orthopaedic surgery cannot be overemphasized because it has aided reduction in intra-operative and post-operative pain which has always been a challenge in surgical practice. It also reduces the risk of haemorrhage and infection. Though there are complications associated with regional anaesthesia, these complications are rare and can be anticipated; thus prompt intervention measures can be instituted. The outcome of every surgical procedure takes into consideration the risks and benefit of the method, and hence, since the benefits of regional anaesthesia in orthopaedic surgery outweighs the risks, it is highly recommended. Regional anaesthesia is of great importance in orthopaedic surgery because it offers continuous but controlled analgesia. It induces hypotension which leads to a reduction in blood loss during operation. It allows early recovery and ambulation of patients, thus reducing the risks associated with prolonged bed stay, which may, in turn, affect the overall outcome of surgery. This review aims to highlight the advantages and challenges of regional anaesthesia in orthopaedic surgery.

Citas

Abenstein, JP; Long, KH; MCGlinch, BP; Dietz, NM. (). Is physician anesthesia cost-effective? Anesthesia and Analgesia. 2004; 98(3): 750-757.

Abrahams MS, Aziz MF, Fu RF, Horn JL. Ultrasound guidance compared with electrical neuro-stimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2009; 102(3): 408-17.

Amata OA. Incidence of post-spinal headache in Africans. West Afr J Med. 1994; 13:53-5.

American Society of Anesthesiologists (ASA). Continuum of Depth of Sedation. Definition of General Anesthesia and Levels of Sedation / Analgesia. [Internet]. WashingtonD.C.: American Society of Anesthesiologists (ASA); October 27, 2004. Available at: http://www.asahq.org/~/

media/Sites/ASAHQ/Files/Public/Resources/standards-guidelines/continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedation-analgesia.pdf.

Arendt K, Segal S. Why Epidurals Do Not Always Work. Rev Obstet Gynecol. 2008; 1(2): 49–55.

Barrington MJ, Watts SA, Gledhill SR, Thomas RD, Said SA, Snyder GL, Tay VS, Jamrozik K. Preliminary results of Australasian Regional Anasthesia Collaboration: a prospective audit of more than 7000 peripheral nerve and plexus blocks for neurologic and other complications. Reg Anaesth Pain Med. 2009; 34:534-41.

Berger JL, Desmonts JM. Loco-regional anesthesia for surgery of limbs. Ann Chir. 1993; 47(5);446-50.

Bier A. Experiments on cocainization of the spinal cord. Deutsche Zeitschrift fur Chirurgie. 1899;51: 361-9.

Carvalho WA, Lemônica L. Mecanismos centrais de transmissão de modulação da dor. Atualização terapêutica. Rev Bras Anestesiol. 1998; 48:221-241.

Corning JL. A further contribution on local medication of the spinal cord, with cases. N Y Med J. 1884; 40: 643-4.

Costley DO, Lorhan PH. Intravenous regional anaesthesia. Survey of Anaesthesiology. 1972; 16(4):359-60.

De Saram M. Accidental total spinal analgesia. Anaesthesia. 1956; 11(1):77-79.

Di Gregorio G, Neal JM, Rosenquist RW, Weinberg GL. Clinical presentation of local anaesthetic system toxicity: a review of published cases. 1979 to 2009. Reg Anesth Pain Med. 2010; 35(2): 181-187.

Diz J.C, Franco A, Bacon DR, Rupreht J, Alvarez J. (eds). The history of anaesthesia: proceedings of Fifth international Symposium. Amsterdam: Elsevier, 2002. 205-6.

Drasner K. Local anaesthetic systemic toxicity: a historical perspective. Reg Anaesth Pain Med. 2010; 35: 162-66.

Eledjam JJ, de la Coussaye JE, Viel E. Techniques of loco-regional anesthesia of the lower limb. Phlebologie. 1989; 42(1):31-43.

Goodwin DRA, Rubenstein N, Otremski I. Intravenous anaesthesia in the upper limb; a review of 225 cases. Int Orthop. 1984;8(1): 51-4.

Guinard JP, Mavrocordatos P, Chiolero R, Carpenter RL. A randomized comparison of intravenous versus lumbar and thoracic epidural fentanyl for analgesia after thoracotomy.

Anesthesiology. 1992; 77(6):1108-1115.

Gupta A, Enlund G, Bengtsson M, Sjoberg F. Spinal anaesthesia for caesarean section following epidural analgesia in labour: A relative contraindication. Int J Obstet Anesth. 1994; 3(3):153-6.

Hatfalvi BI. “Postulated Mechanisms for Post Dural Puncture Headache: Clinical experience and Review of Laboratory Models”. Reg Anesth. 1995; 20 (4): 329-36.

Ismail S. Ultrasound Guided Central Neuraxial Block. Anaesth Pain & Intensive Care. 2015; 19(3):361-365.

Junger A, Klasen J, Hartmann B, Benson M, Rohrig R, Kuhn D, Hempelmann G. Shorter discharge time after regional or intravenous anaesthesia in combination with laryngeal

mask airway compared with balanced anaesthesia with endotracheal intubation. Anaesthesiol. 2002; 19(2):119.

Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997; 78(5): 606-617.

Lee LA, Posner KL, Cheney FW, Caplan RA, Domino KB. Complications associated with eye blocks and peripheral nerve blocks: an American Society of Anaesthesiologists closed claims analysis. Reg Anesth Pain Med. 2008; 33:416-422.

Leivers D. Total spinal anesthesia following early prophylactic epidural blood patch. Anesthesiology. 1990; 73:1287-9.

Liu SS, Carpenter RL, Mackey DC. Thirlby RC, Rupp SM, Shine TS, Feinglass NG, Metzger PP, Fulmer JT, Smith SL. Effects of perioperative analgesic technique on rate of recovery after colon surgery. Anesthesiology. 1995; 83(4):757-765.

Liu SS, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Their role in postoperative outcome. Anesthesiology. 1995; 82:1474-1506.

Marx GF. “The first spinal anaesthesia. Who deserves the laurels?”. Reg Anesth. 1994;19 (6): 429-30.

Milosavljevic SB, Pavlovic, AP, Trpkovic SV, Ilic AN, Sekulic AD. Influence of Spinal and General Anesthesia on the Metabolic, Hormonal, and Hemodynamic Response in Elective Surgical Patients. Med Sci Monit. 2014; 20: 1833–1840.

Mulroy MF, Hejtmanek MR. Prevention of local anaesthetic system toxicity. Reg Anaesth Pain Med. 2010; 35: 177-80.

Neal JM, Bernards CM, Butterworth JF, Di Gregorio G, Drasner K, Hejtmanek MR, Mulroy MF, Rosenquist RW, Weinberg, GL. American Society Of Regional Anaesthesia Practice Advisory on local anaesthetic systemic toxicity. Reg Anesth Pain Med. 2010; 35:152-161.

O’ Donell BD, Iohom G. Regional anaesthesia technique for ambulatory orthopedic surgery. Curr Opin Anaesthesiol. 2008; 21(6): 723-8.

Park PC, Berry PD, Larson MD. Total Spinal Anesthesia following Epidural Saline Injection after Prolonged Epidural Anesthesia. Anesthesiology 11. 1998; 89: 1267-1270.

Popping DM, Zahn PK, Van Aken HK, Dasch B, Boche R, Pogatzki-Zahn EM. Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients

between 1998 and 2006 (2nd revision): a database analysis of prospectively raised data. Br J Anesth. 2008;101(6): 832-40.

Ross S, Scarborough CD. Total spinal anesthesia following brachial plexus block. Anesthesiology. 1973; 39:458-60.

Sites BD, Taenzer AH, Herrick MD, Gilloon C, Antonakakis J, Richnis J, Beach ML. Incidence of local anaesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound guided nerve blocks: an analysis from a prospective clinical registry. Reg Anaesth Pain Med. 2012; 37(5):478-482.

Tessler MJ, Kleiman SJ. Spinal anaesthesia for patients with previous lower limb amputations. Anaesthesia. 1994; 49(5):439-41.

Tucker GT, Moore DC, Bridenbaugh PO, Bridenbaugh LD, Thompson GE. Systemic absorption of mepivacaine in commonly used regional block procedures. Anesthesiology. 1972; 37:277-87.

Turnbull DK, Shepherd DB. ”Post dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003; 91(5): 718-29.

Vincent O, Hubler M, Kirschner S, Koch T. The value of regional anaesthesia and general anaesthesia in orthopaedic surgery. Orthopade. 2007; 36(6): 529-36.

Waters JH, Leivers D, Hullander M. Response to spinal anesthesia after inadequate epidural anesthesia (letter). Anesth Analg. 1994; 78:1033-4.

Yeager MP, Glass DD, Neff RK, Brinck-Johnsen T. Epidural anesthesia and analgesia in high-risk surgical patients. Anesthesiology. 1987; 66(6):729-736.