Regional anaesthesia and subsequent long-term pain.
The incidence of long-term pain (between 1 and 48 weeks and at 2 year follow-up) unrelated to the surgical site following either regional brachial plexus or general anaesthesia was determined. In 834 patients with regional anaesthesia, the incidence (11.1%) was significantly higher than in the 86 patients with general anaesthesia (3.6%; P = 0.03). The incidence of pain was not significantly different among four common techniques of positioning the needle tip in the axillary sheath (9.9 to 11.1%). Parascalene blocks had a slightly but not significantly higher rate (16.3%). A regional re-block was not associated with a higher incidence when compared to those blocked only once. A more distal local re-block was associated with a higher incidence of pain (23%). 2 years post-operatively, 0.5% of patients had pain related to the regional block. A significant proportion of patients developed some long-lasting post-operative pain following regional brachial plexus anaesthesia, although ultimate morbidity was minimal.
Weeks
L
L
Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky.
Barry
A
A
Wolff
T
T
Firrell
J
J
Scheker
L
L
D000765:Anesthesia, Conduction / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000009:adverse effects / Q000706:statistics & numerical data; D002908:Chronic Disease; D017558:Elective Surgical Procedures; D004630:Emergencies; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007629:Kentucky / Q000453:epidemiology; D009339:Needles / Q000009:adverse effects; D009407:Nerve Block / Q000009:adverse effects / Q000706:statistics & numerical data; D009408:Nerve Compression Syndromes / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D014111:Tourniquets / Q000009:adverse effects