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PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

Year 2012, Volume: 2 Issue: 3, 195 - 200, 01.09.2012

Abstract

Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to respiration and hemodynamics and shortness of recovery time. If a plexus brachialis catheter is placed, control of pain is provided without using systemic narcotic analgesic. With these advantages; rare life threatening potential complications can be seen which are pneumothorax, hematoma, neuritis, allergy, systemic and neurologic complications. In this compilation we aimed to review again the complications of upper extremity nerve blocks according to block type.

References

  • Erdine S. Rejyonel Anestezi. Nobel Tıp Kitabevi:İstanbul; 2005.
  • Whiteside J.B,Wildsmith J.A.W. Developments in local anaesthetic drugs. Br Journal Anaesth 2001;87(1):27-35.
  • Valentin N, Lomholt B, Jensen JS, Hejgaard N, Kreiner S. Spinal or general anaesthesia for surgery of the fractured hip? A prospective study of mortality in 578 patients. Br J Anaesth 1986 ;58(3):284-291.
  • Brown DL. Brachial plexus anesthesia: an analysis of op- tions.Yale J Biol Med 1993;66(5):415-431.
  • Schulz-Stübner S. Brachial plexus. Anesthesia and analgesia. Anaesthesist 2003;52(7):643-656.
  • Gaither K. Cocaine Abuse in Pregnancy: An Evolution from Panacea to Pandemonium. Southern Med J 2008;101(8):783-784. 7. dos Reis A Jr. . Eulogy to August Karl Gustav Bier on the 100th anniversary of intravenous regional block and the 110th anniversary of the spinal block. Rev Bras Anestesiol 2008;58(4):409-424.
  • Urmey WF. Upper Extremity Blocks. In: Brown DL, editor. Regional Anesthesia and Analgesia. Philadelphia: W.B. Saunders Company 1996.p.266-268.
  • Özyalçın SN, Erdine S. Üst ekstremite somatik blokları. Rejyonel Anestezi. Nobel Tıp Kitabevi:İstanbul; 2005.
  • Çelik F, Tüfek A, Temel V ve ark. Spinal anestezi ve üst ekstremite periferik sinir bloğu kombinasyonu: iki olgu sunumu. Dicle Tıp Dergisi:Diyarbakır; 2010.
  • Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J
  • Anaesth 2005;94(1):7-17.
  • Koscielniak-Nielsen ZJ, Rasmussen H, Hesselbjerg L, Nielsen TP, Gürkan Y. Infraclavicular block causes less discomfort than axillary block in ambulatory patients. Acta Anaesthesiol Scand 2005;49(7):1030-1034.
  • Gürkan Y, Acar S, Solak M, Toker K. Comparison of nerve stimulation vs. ultrasound guided lateral sagittal infraclavicular block. Acta Anaesthesiol Scand 2008;52(6):851-855.
  • Kapral S, Krafft P, Gosch M, Fleischmann D, Weinstabl C. Ultrasound imaging for stellate ganglion block: direct visualization of puncture site and local anesthetic spread. A pilot study. Reg Anesth 1995;20(4):323-328.
  • Liu FC, Liou JT, Tsai YF, Li AH, Day YY, Hui YL, Lui PW. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method. Chang Gung Med J 2005;28(6):396-402.
  • Sandhu NS, Manne JS, Medabalmi PK, Capan LM. Sonographically guided infraclavicular brachial plexus block in adults: a retrospective analysis of 1146 cases. J Ultrasound Med 2006;25(12):1555-1561.
  • Marhofer P, Sitzwohl C, Greher M et al (2004) Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children. Anaesthesia 59(7):642–646.
  • Oberndorfer U, Marhofer P, Bo¨senberg A et al (2007) Ultrasonographic guidance for sciatic and femoral nerve blocks in children. Br J Anaesth 98(6):797–801.
  • D’Alessio JG, Weller RS, Rosenblum M. Activation of the Bezold-Jarisch reflex in the sitting position for shoulder arthroscopy using interscalene block. Anesth Analg 1995 ;80(6):1158-1162.
  • Kahn RL, Hargett MJ. Beta-adrenergic blockers and vasovagal episodes during shoulder surgery in the sitting position under interscalene block. Anesth Analg 1999;88(2):378-381.
  • Korevaar WC, Burney RG, Moore PA. Convulsions during stellate ganglion block: a case report. Anesth Analg 1979;58(4):329–330.
  • Salinas FV, Neal JM. A tale of two needle passes. Reg Anesth Pain Med 2008;33(3):195–198.
  • Borgeat, A.; Blumenthal, S. Complications in Regional Anesthesia and Pain Medicine. Neal, JM.;Rathmell, JP., editors. Philadelphia: Saunders Elsevier; 2007. p. 157-163.
  • Borgeat A, EkatodramisG, Kalberer F, Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology 2001;95(4):875-880.
  • Kessler J, Schafhalter-Zoppoth I, Gray AT. An ultrasound study of the phrenic nerve in the posterior cervical triangle: implications for the interscalene brachial plexus block. Reg Anesth Pain Med 2008;33(6):545–550.
  • Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth.Analg 1991;72(4):498–503.
  • Urmey WF, McDonald M. Hemidiaphragmatic paresis during interscalene brachial plexus block:effects on pulmonary function and chest wall mechanics. Anesth Analg 1992;74(3):352-357.
  • Hickey R, Garland TA, Ramamurthy S. Subclavian perivascular block: influence of location of paresthesia. Anesth Analg 1989;68(6):767-771.
  • Borgeat A, Blumenthal S. Unintended destinations of local anesthetics.İn: Neal JM, Rathmell JP,eds. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007.p.157-163.
  • Boezaart AP, De Beer JF, Nell ML. Early experience with continuous cervical paravertebral block using a stimulating catheter. Reg Anesth Pain Med 2003;28(5):406-413.
  • Urmey WF. Pulmonary complications. In: Neal JM; Rathmell JP, editors. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007. p. 147-156.
  • Despars JA, Sassoon CS, Light RW. Significance of iatrogenic pneumothoraces. Chest 1994;105(4):1147–1150.
  • Weissberg D, Refaely Y. Pneumothorax: Experience with 1,199 patients. Chest 2000; 117(5):1279–85.
  • Moore DC, Bridenbaugh LD. Pneumothorax; Its incidence following brachial plexus block analgesia. Anesthesiology 1954;15(5):475-479.
  • Neuberger M, Breitbarth J, Reisig F, Lang D, Buttner J. Complications and adverse events in continuous peripheral regional anesthesia. Results of investigations on 3,491 catheters. Anaesthesist 2006;55(1):33-40.
  • Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med 1996;334(4):240-245.
  • Capdevila X, Pirat P, Bringuier S, Gaertner E, Singelyn FJ, Bernard N, et al. Continuous peripheral nerve blocks in hospital wards after orthopedic surgery : a multicenter prospective analysis of the quality of postoperative analgesia and complications 2005;103(5):1035–1045.
  • Hebl JR. The importance and implications of aseptic techniques during regional anesthesia. Reg Anesth. Pain Med 2006; 31(4):311–323.
  • Stan TC, Krantz MA, Solomon DL, Poulos JG, Chaouki K. The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1,000 consecutive patients. Reg Anesth 1995;20(6):486–492.
  • Bergman BD, Hebl JR, Kent J, Horlocker TT. Neurologic complications of 405 consecutive continuous axillary catheters. Anesth Analg 2003;96(1):247-252.
  • Chabal C, Russell LC, Lee R. Tourniquet-induced limb ischemia: a neurophysiologic animal model. Anesthesiology 1990;72(6):1038–1044.
  • Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg 1999;88(4):847–852.
  • Jeng CL, Torrillo TM, Rosenblatt MA. Complications of peripheral
  • Br J Anaesth 2010;105 Suppl 1:97-107.
  • Hebl, JR. Peripheral nerve injury. In: Neal, JM.; Rathmell, JP., editors. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007. p. 125-140.
  • Horlocker TT, Kufner RP, Bishop AT, Maxson PM, Schroeder DR. The risk of persistent paresthesia is not increased with repeated axillary block. Anesth Analg 1999;88(2):382–387.
  • Selander D, Edshage S, Wolff T. Paresthesiae or no paresthesiae? Nerve lesions after axillary blocks. Acta Anaesth Scand 1979;23(1):27–33.
  • Selander D, Ghuner KG, Lundborg G. Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma. Acta Anaesthesiol Scand 1977;21(3):182–188.
  • Anesthesiology nevre blocks.

ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI

Year 2012, Volume: 2 Issue: 3, 195 - 200, 01.09.2012

Abstract

Periferik blokların başarılı olması ve cerrahiye uygun tekniğin seçilebilmesi ancak iyi anatomi bilgisiyle olabilmektedir. Tek injeksiyonla pleksus brakiyalise uygulanan bölgesel üst ekstremite periferik blok anestezisi, günübirlik cerrahide en çok tavsiye edilen anestezi yöntemidir. Rejyonel anestezi türü olan periferik sinir bloklarının; genel anesteziye ve santral bloklara göre en önemli avantajları solunuma ve hemodinamiye etkisinin az olması, derlenme süresinin kısa olmasıdır. Pleksus brakiyalise kateter yerleştirilirse, sistemik narkotik analjezik kullanmadan ağrı kontrolü sağlanabilir. Avantajlarının yanında nadirde olsa yaşamı tehdit edebilecek potansiyel komplikasyonlarda görülebilir. Pnömotoraks, hematom, nörit, allerji, sistemik ve nörolojik komplikasyonlar bunlardan bazılarıdır. Biz bu derlemede üst ekstremite sinir bloklarında karşımıza çıkabilecek komplikasyonları blok tipine göre gözden geçirmeyi amaçladık.

References

  • Erdine S. Rejyonel Anestezi. Nobel Tıp Kitabevi:İstanbul; 2005.
  • Whiteside J.B,Wildsmith J.A.W. Developments in local anaesthetic drugs. Br Journal Anaesth 2001;87(1):27-35.
  • Valentin N, Lomholt B, Jensen JS, Hejgaard N, Kreiner S. Spinal or general anaesthesia for surgery of the fractured hip? A prospective study of mortality in 578 patients. Br J Anaesth 1986 ;58(3):284-291.
  • Brown DL. Brachial plexus anesthesia: an analysis of op- tions.Yale J Biol Med 1993;66(5):415-431.
  • Schulz-Stübner S. Brachial plexus. Anesthesia and analgesia. Anaesthesist 2003;52(7):643-656.
  • Gaither K. Cocaine Abuse in Pregnancy: An Evolution from Panacea to Pandemonium. Southern Med J 2008;101(8):783-784. 7. dos Reis A Jr. . Eulogy to August Karl Gustav Bier on the 100th anniversary of intravenous regional block and the 110th anniversary of the spinal block. Rev Bras Anestesiol 2008;58(4):409-424.
  • Urmey WF. Upper Extremity Blocks. In: Brown DL, editor. Regional Anesthesia and Analgesia. Philadelphia: W.B. Saunders Company 1996.p.266-268.
  • Özyalçın SN, Erdine S. Üst ekstremite somatik blokları. Rejyonel Anestezi. Nobel Tıp Kitabevi:İstanbul; 2005.
  • Çelik F, Tüfek A, Temel V ve ark. Spinal anestezi ve üst ekstremite periferik sinir bloğu kombinasyonu: iki olgu sunumu. Dicle Tıp Dergisi:Diyarbakır; 2010.
  • Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J
  • Anaesth 2005;94(1):7-17.
  • Koscielniak-Nielsen ZJ, Rasmussen H, Hesselbjerg L, Nielsen TP, Gürkan Y. Infraclavicular block causes less discomfort than axillary block in ambulatory patients. Acta Anaesthesiol Scand 2005;49(7):1030-1034.
  • Gürkan Y, Acar S, Solak M, Toker K. Comparison of nerve stimulation vs. ultrasound guided lateral sagittal infraclavicular block. Acta Anaesthesiol Scand 2008;52(6):851-855.
  • Kapral S, Krafft P, Gosch M, Fleischmann D, Weinstabl C. Ultrasound imaging for stellate ganglion block: direct visualization of puncture site and local anesthetic spread. A pilot study. Reg Anesth 1995;20(4):323-328.
  • Liu FC, Liou JT, Tsai YF, Li AH, Day YY, Hui YL, Lui PW. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method. Chang Gung Med J 2005;28(6):396-402.
  • Sandhu NS, Manne JS, Medabalmi PK, Capan LM. Sonographically guided infraclavicular brachial plexus block in adults: a retrospective analysis of 1146 cases. J Ultrasound Med 2006;25(12):1555-1561.
  • Marhofer P, Sitzwohl C, Greher M et al (2004) Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children. Anaesthesia 59(7):642–646.
  • Oberndorfer U, Marhofer P, Bo¨senberg A et al (2007) Ultrasonographic guidance for sciatic and femoral nerve blocks in children. Br J Anaesth 98(6):797–801.
  • D’Alessio JG, Weller RS, Rosenblum M. Activation of the Bezold-Jarisch reflex in the sitting position for shoulder arthroscopy using interscalene block. Anesth Analg 1995 ;80(6):1158-1162.
  • Kahn RL, Hargett MJ. Beta-adrenergic blockers and vasovagal episodes during shoulder surgery in the sitting position under interscalene block. Anesth Analg 1999;88(2):378-381.
  • Korevaar WC, Burney RG, Moore PA. Convulsions during stellate ganglion block: a case report. Anesth Analg 1979;58(4):329–330.
  • Salinas FV, Neal JM. A tale of two needle passes. Reg Anesth Pain Med 2008;33(3):195–198.
  • Borgeat, A.; Blumenthal, S. Complications in Regional Anesthesia and Pain Medicine. Neal, JM.;Rathmell, JP., editors. Philadelphia: Saunders Elsevier; 2007. p. 157-163.
  • Borgeat A, EkatodramisG, Kalberer F, Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology 2001;95(4):875-880.
  • Kessler J, Schafhalter-Zoppoth I, Gray AT. An ultrasound study of the phrenic nerve in the posterior cervical triangle: implications for the interscalene brachial plexus block. Reg Anesth Pain Med 2008;33(6):545–550.
  • Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth.Analg 1991;72(4):498–503.
  • Urmey WF, McDonald M. Hemidiaphragmatic paresis during interscalene brachial plexus block:effects on pulmonary function and chest wall mechanics. Anesth Analg 1992;74(3):352-357.
  • Hickey R, Garland TA, Ramamurthy S. Subclavian perivascular block: influence of location of paresthesia. Anesth Analg 1989;68(6):767-771.
  • Borgeat A, Blumenthal S. Unintended destinations of local anesthetics.İn: Neal JM, Rathmell JP,eds. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007.p.157-163.
  • Boezaart AP, De Beer JF, Nell ML. Early experience with continuous cervical paravertebral block using a stimulating catheter. Reg Anesth Pain Med 2003;28(5):406-413.
  • Urmey WF. Pulmonary complications. In: Neal JM; Rathmell JP, editors. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007. p. 147-156.
  • Despars JA, Sassoon CS, Light RW. Significance of iatrogenic pneumothoraces. Chest 1994;105(4):1147–1150.
  • Weissberg D, Refaely Y. Pneumothorax: Experience with 1,199 patients. Chest 2000; 117(5):1279–85.
  • Moore DC, Bridenbaugh LD. Pneumothorax; Its incidence following brachial plexus block analgesia. Anesthesiology 1954;15(5):475-479.
  • Neuberger M, Breitbarth J, Reisig F, Lang D, Buttner J. Complications and adverse events in continuous peripheral regional anesthesia. Results of investigations on 3,491 catheters. Anaesthesist 2006;55(1):33-40.
  • Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med 1996;334(4):240-245.
  • Capdevila X, Pirat P, Bringuier S, Gaertner E, Singelyn FJ, Bernard N, et al. Continuous peripheral nerve blocks in hospital wards after orthopedic surgery : a multicenter prospective analysis of the quality of postoperative analgesia and complications 2005;103(5):1035–1045.
  • Hebl JR. The importance and implications of aseptic techniques during regional anesthesia. Reg Anesth. Pain Med 2006; 31(4):311–323.
  • Stan TC, Krantz MA, Solomon DL, Poulos JG, Chaouki K. The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1,000 consecutive patients. Reg Anesth 1995;20(6):486–492.
  • Bergman BD, Hebl JR, Kent J, Horlocker TT. Neurologic complications of 405 consecutive continuous axillary catheters. Anesth Analg 2003;96(1):247-252.
  • Chabal C, Russell LC, Lee R. Tourniquet-induced limb ischemia: a neurophysiologic animal model. Anesthesiology 1990;72(6):1038–1044.
  • Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg 1999;88(4):847–852.
  • Jeng CL, Torrillo TM, Rosenblatt MA. Complications of peripheral
  • Br J Anaesth 2010;105 Suppl 1:97-107.
  • Hebl, JR. Peripheral nerve injury. In: Neal, JM.; Rathmell, JP., editors. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Saunders Elsevier; 2007. p. 125-140.
  • Horlocker TT, Kufner RP, Bishop AT, Maxson PM, Schroeder DR. The risk of persistent paresthesia is not increased with repeated axillary block. Anesth Analg 1999;88(2):382–387.
  • Selander D, Edshage S, Wolff T. Paresthesiae or no paresthesiae? Nerve lesions after axillary blocks. Acta Anaesth Scand 1979;23(1):27–33.
  • Selander D, Ghuner KG, Lundborg G. Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma. Acta Anaesthesiol Scand 1977;21(3):182–188.
  • Anesthesiology nevre blocks.
There are 49 citations in total.

Details

Primary Language Turkish
Journal Section Review Article
Authors

Hakan Tapar This is me

Mustafa Süren This is me

Ziya Kaya This is me

Semih Arıcı This is me

Serkan Karaman This is me

Mürsel Kahveci This is me

Publication Date September 1, 2012
Published in Issue Year 2012 Volume: 2 Issue: 3

Cite

APA Tapar, H., Süren, M., Kaya, Z., Arıcı, S., et al. (2012). ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI. Çağdaş Tıp Dergisi, 2(3), 195-200.
AMA Tapar H, Süren M, Kaya Z, Arıcı S, Karaman S, Kahveci M. ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI. J Contemp Med. September 2012;2(3):195-200.
Chicago Tapar, Hakan, Mustafa Süren, Ziya Kaya, Semih Arıcı, Serkan Karaman, and Mürsel Kahveci. “ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI”. Çağdaş Tıp Dergisi 2, no. 3 (September 2012): 195-200.
EndNote Tapar H, Süren M, Kaya Z, Arıcı S, Karaman S, Kahveci M (September 1, 2012) ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI. Çağdaş Tıp Dergisi 2 3 195–200.
IEEE H. Tapar, M. Süren, Z. Kaya, S. Arıcı, S. Karaman, and M. Kahveci, “ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI”, J Contemp Med, vol. 2, no. 3, pp. 195–200, 2012.
ISNAD Tapar, Hakan et al. “ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI”. Çağdaş Tıp Dergisi 2/3 (September 2012), 195-200.
JAMA Tapar H, Süren M, Kaya Z, Arıcı S, Karaman S, Kahveci M. ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI. J Contemp Med. 2012;2:195–200.
MLA Tapar, Hakan et al. “ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI”. Çağdaş Tıp Dergisi, vol. 2, no. 3, 2012, pp. 195-00.
Vancouver Tapar H, Süren M, Kaya Z, Arıcı S, Karaman S, Kahveci M. ÜST EKSTREMİTE PERİFERİK BLOK ANESTEZİSİ VE KOMPLİKASYONLARI. J Contemp Med. 2012;2(3):195-200.