title: Orthopaedic anaesthesia for upper extremity procedures in a Nigerian hospital.
abstract: General anaesthesia and regional anaesthesia have been used successfully for upper extremity orthopaedic procedures. Despite the advantages of regional anaesthesia, there is low utilisation in Nigeria. In this study, we assessed the types of anaesthesia employed for upper extremity surgeries in our centre.
  
  
  
  After obtaining approval from the institutional ethics committee, all the patients who had upper extremity surgeries from 1 January 2011 to 31 December 2012 were included in this review. Both prospective and retrospective data were gathered. The choice of anaesthesia was at the discretion of the attending anaesthetist.
  
  
  
  A total of 226 patients with a male-to-female ratio of 1.6:1 and median age of 35.0 (range 2 - 89) years, had orthopaedic upper extremity procedures during the study period. Sixty-three cases (27.9%) had general anaesthesia, 5 (2.2%) combined regional and general anaesthesia while 158 (69.9%) had regional blocks. The regional blocks comprised 145 (89%) different approaches to the brachial plexus and 18 (11%) local anaesthetic infiltrations. The arm was the site mostly operated upon; while supraclavicular and axillary brachial plexus blocks were performed in equal amounts. In 14 (6.2%) patients, brachial plexus blocks were performed with spinal anaesthesia because of concomitant iliac crest bone grafts. While the duration of surgery did not differ significantly, regional anaesthesia provided a significantly longer duration of anaesthesia than general anaesthesia (251 ± 70.8 min versus 141.3 ± 65.5 min; p = 0.0000001).
  
  
  
  There is a high use of regional anaesthesia for upper extremity orthopaedic surgeries in our centre, which is a positive development in a resource limited setting.
authors.affiliation: Department of Anaesthesia, University College Hospital, Ibadan, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Rukewe
authors.affiliation: Department of Epidemiology and Medical Statistics, College of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Fatiregun
authors.affiliation: Department of Orthopaedics & Trauma, University College Hospital, Ibadan, Nigeria.
authors.forename: T O
authors.initials: TO
authors.lastname: Alonge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D001132:Arm / Q000601:surgery*; D001917:Brachial Plexus; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009549:Nigeria; D009985:Orthopedics; D011446:Prospective Studies; D012189:Retrospective Studies; D034941:Upper Extremity / Q000601:surgery*; D055815:Young Adult