Background & Aims
The emergence of ultrasound-guided techniques has allowed the development of new approaches to control acute and chronic pain, reducing block failure and complications in relation to the anatomical reference. Recent data suggest that Ultrasound guided regional anesthesia generates improved success rates and reductions in performance times in comparison to traditional approaches. This work aims to evaluate the analgesic efficacy of ultrasound-guided blockade in the Central Hospital of Maputo.
Methods
A cross-sectional study was carried out between September and November 2023 on 100 patients treated in the surgical center for scheduled surgeries and in the Pain Unit of the Maputo Central Hospital. All patients who underwent the technique between 2014 and 2022 were included, and cases with omission of information such as initial and final information, as well as the type of analgesic applied, were excluded. The diagnoses, type of anesthetic used for the technique, period in which the technique was performed (pre- or post-operative), type of block applied and intensity of initial and final pain were also evaluated. Data analysis was carried out using the SPSS®25 program.
Results
Of the 100 patients, 54% were male. Age – median [1st Quartile; 3rd Quartile], min-max: 39.5 [32; 55], 13-104 years. The acute pain technique was performed in 49%. The main specialties were: Orthopedics 61%, General Surgery 24%, Gynecology 8%. The main diagnoses in the theatre were secondary to upper limb fractures (71.4%) and lower limb fractures (20.4%). In the Pain Unit, the technique was performed frequently for infraumbilical pain in 85.7%. TAP block was performed in 42%, axillary brachial plexus block in 20%, supraclavicular brachial plexus block in 16%. The main drugs used were: analgesic bupivacaine with corticosteroids (35%), simple analgesic bupivacaine (30%) and bupivacaine with corticosteroids and ozone (12%). For chronic pain, 28% had an initial pain intensity of 10, 23% had a pain intensity of 8, and 19.2% had a pain intensity of 9 on the numerical scale. For acute pain, 87.5% of patients had zero final pain intensity. TAP block had an 85.8% response with pain less 3.
Conclusions
The ultrasound-guided block technique proved to be effective for controlling acute and chronic pain both in the theatre and in the Pain Unit respectively. In the theatre 87.5% of patients had effective pain control after performing the technique and in the Pain Unit, 97.7% had an effective response.
References
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2.Kim TE, Ganaway T, Harrison TK, et al. Implementation of clinical practice changes by experienced anesthesiologists after simulation-based ultrasound-guided regional anesthesia training. Korean J Anesthesiol. 2017;70(3):318-326. doi:10.4097/kjae.2017.70.3.318
3.Pester JM, Hendrix JM, Varacallo M. Brachial Plexus Block Techniques. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 4, 2023.
4.Pushpanathan E, Setty T, Carvalho B, Sultan P. A Systematic Review of Postoperative Pain Outcome Measurements Utilised in Regional Anesthesia Randomized Controlled Trials. Anesthesiol Res Pract. 2018;2018:9050239. Published 2018 Jul 29. doi:10.1155/2018/9050239.
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Presenting Author
Emília Pinto
Poster Authors
Emília Pinto
PhD
Higher Institute of Sciences and Technologies of Mozambique
Lead Author
Topics
- Treatment/Management: Interventional Therapies – Injections/Blocks