Factors associated with failed brachial plexus regional anesthesia for upper limb surgery

  • Diego Alberto Moreno-Martinez a. Hospital Universitario San Ignacio, Bogotá D. C, Colombia. b. School of Medicine, Pontificia Universidad Javeriana, Bogotá D. C, Colombia
  • Ana Helena Perea-Bello a. Hospital Universitario San Ignacio, Bogotá D. C, Colombia. b. School of Medicine, Pontificia Universidad Javeriana, Bogotá D. C, Colombia
  • Judy Lorena Diaz-Bohada Hospital Universitario San Ignacio, Bogotá D. C, Colombia
  • Diana Margarita Garcia-Rodriguez Hospital Universitario San Ignacio, Bogotá D. C, Colombia
  • Verónica Echeverri-Mallarino Hospital Universitario San Ignacio, Bogotá D. C, Colombia
  • Maury Julieth Valencia-Peña Pontificia Universidad Javeriana, Bogotá D. C., Colombia
  • Walter Osorio-Cardona Hospital Universitario San Ignacio, Bogotá D. C, Colombia
  • Paola Nathaly Silva-Enriquez Pontificia Universidad Javeriana, Bogotá D. C., Colombia
Keywords: Ultrasonography interventional, Anesthesia conduction, Nerve block, Brachial plexus, Ultrasonography

Abstract

Introduction: Brachial plexus block as an anesthetic technique for upper limb surgery has some advantages over general anesthesia. The technique is widely used in our practice, with high effectiveness and adequate safety profile. However, the relationship between block failure and failure-determining factors has not been measured.

Objectives: To identify and quantify brachial plexus block failure-associated factors for upper limb surgery as an initial observation aimed at developing prevention-oriented risk profiles and strategies.

Materials and methods: An analytical observational study was conducted by collecting data from electronic medical records of upper limb surgery using brachial plexus block from the San Ignacio University Hospital between 2011 and 2012. Block failures were identified using standardized clinical criteria, measuring potentially associated factors. Dichotomous comparisons were made and uni-and multivariate logistic regression analysis was performed to identify potential statistically significant variables, based on failed cases and successful controls.

Results: None of the proposed factors was independently associated with failure of brachial plexus block. A qualitative description of failed cases presented confounding factors associated with local practices and the failure characteristics did not show a clinically plausible trend.

Conclusions: There were no factors determined by patient, anesthetic procedure, surgical procedure and operator that could be independently associated with brachial plexus block failure. The suggestion is to fine-tune the definition of failures, not just in the research environment, but in the current clinical practice; to improve the anesthesia records to rise the numbers and the quality of data bases for a quantitative determination of the risk of peripheral regional anesthesia failure and design prevention strategies focused on risk groups.

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How to Cite
1.
Moreno-Martinez DA, Perea-Bello AH, Diaz-Bohada JL, Garcia-Rodriguez DM, Echeverri-Mallarino V, Valencia-Peña MJ, Osorio-Cardona W, Silva-Enriquez PN. Factors associated with failed brachial plexus regional anesthesia for upper limb surgery. Colomb. j. anesthesiol. [Internet]. 2016Oct.1 [cited 2020Sep.27];44(4):292–298. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/605

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Published
2016-10-01
How to Cite
1.
Moreno-Martinez DA, Perea-Bello AH, Diaz-Bohada JL, Garcia-Rodriguez DM, Echeverri-Mallarino V, Valencia-Peña MJ, Osorio-Cardona W, Silva-Enriquez PN. Factors associated with failed brachial plexus regional anesthesia for upper limb surgery. Colomb. j. anesthesiol. [Internet]. 2016Oct.1 [cited 2020Sep.27];44(4):292–298. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/605
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