title: Ultrasound-guided supraclavicular brachial plexus block in upper limb surgery: outcomes and patient satisfaction.
abstract: We examined the outcomes and levels of patient satisfaction in 202 consecutive cases of ultrasound-guided supraclavicular brachial plexus block (SBPB) in upper limb surgery performed between September 2007 and March 2010. All blocks were performed by orthopaedic surgeons using ultrasound visualisation with a high-frequency linear probe. The probe was placed in the coronal-oblique plane in the supraclavicular fossa, and the puncture was 'in-plane' from lateral to medial. Most of the blocks were performed with 0.75% ropivacaine/1% lidocaine (1:1), with or without adrenaline in 1:200 000 dilution. In 201 patients (99.5%) the brachial plexus block permitted surgery without conversion to general anaesthesia. The mean procedure time for block was 3.9 min (2 to 12), the mean waiting time for surgery was 34.1 min (10 to 64), the mean surgical time was 75.2 min (6 to 232), and the mean duration of post-anaesthetic analgesia was 437 min (171 to 992). A total of 20 patients (10%) developed a transient Horner's syndrome. No nerve injury, pneumothorax, arterial puncture or systemic anaesthetic toxicity were recorded. Most patients (96.7%) were satisfied with ultrasound-guided SBPB. This study demonstrates the efficacy and safety of ultrasound-guided SBPB for orthopaedic surgery on the upper limb.
authors.affiliation: Hoshigaoka Koseinenkin Hospital, Department of Orthopaedic Surgery, 4-8-1 Hoshigaoka, Hirakata-shi, Osaka 573-8511, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Gamo
authors.affiliation: Hoshigaoka Koseinenkin Hospital, Department of Orthopaedic Surgery, 4-8-1 Hoshigaoka, Hirakata-shi, Osaka 573-8511, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kuriyama
authors.affiliation: Moriguchi Keijinkai Hospital, Department of Orthopaedic Surgery, 2-47-12, Yakumohigashi, Moriguchi-shi, Osaka 570-0021, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Higuchi
authors.affiliation: Hoshigaoka Koseinenkin Hospital, Department of Orthopaedic Surgery, 4-8-1 Hoshigaoka, Hirakata-shi, Osaka 573-8511, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Uesugi
authors.affiliation: Hoshigaoka Koseinenkin Hospital, Department of Orthopaedic Surgery, 4-8-1 Hoshigaoka, Hirakata-shi, Osaka 573-8511, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakase
authors.affiliation: Hoshigaoka Koseinenkin Hospital, Department of Orthopaedic Surgery, 4-8-1 Hoshigaoka, Hirakata-shi, Osaka 573-8511, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hamada
authors.affiliation: Shijonawate Gakuen University, 6-45 Gakuen-cho, Daito-shi, Osaka 574-0001, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawai
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000187:drug effects*; D002968:Clavicle; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D034941:Upper Extremity / Q000601:surgery
chemical_list: D000779:Anesthetics, Local
keywords: Adverse effects; Outcomes; Patient satisfaction; Supraclavicular brachial plexus block; Ultrasound; Upper limb surgery