REGIONAL ANAESTHESIA IN A TERTIARY HAND SURGERY UNIT: 1791 CASES OVER ONE YEAR

Abstract

The use of regional anaesthesia for upper limb surgery has been increasing in popularity recently. It is safe, effective and has financial benefits. We report the activity in a tertiary hand surgery unit over one year. This department performs elective and trauma surgery between 8am and 7pm. Out of hours surgery is performed in main theatres.

A total of 3335 cases were performed in Hand Surgery theatres between 1st August 2008 and 1st August 2009. Of these, 1791 had a regional block. The ages of these patients ranged from 13 to 92 years (Median = 46 years, Mean = 47 years). 1030 were male and 761 were female. 1011 regional block procedures were performed by a Consultant Anaesthetist, with 266 performed by a trainee and 472 by non-career grade. 646 procedures were for trauma surgery with 1145 for elective surgery. 87 procedures were arthroscopic. A vast range of surgery was safely performed under regional block. There were no significant complications.

All regional nerve blocks were performed with the aid of ultrasound. Training of junior anaesthetists was benefited by performing the nerve blocks. Patients required very little time to recover following nerve block when compared to recovery after general anaesthesia, with resultant reduction in resource requirements.

We conclude that the use of regional nerve block anaesthesia for hand surgery benefits both the patient and the hospital.