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KMID : 1155520140090010019
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Anesthesia and Pain Medicine
2014 Volume.9 No. 1 p.19 ~ p.23
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A comparison of general anesthesia versus axillary brachial plexus block for hand and wrist surgery in the view of patient satisfaction
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Lee Mi-Geum
Kim Hong-Soon
Lee Dong-Chul
Jung Wol-Seon
Chang Young-Jin
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Abstract
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Background: We evaluated whether the analgesic superiority of regional block over general anesthesia improves patient satisfaction.
Methods:Patients were anesthetized with either general anesthe-sia (GA) (n = 30) or axillary brachial plexus block (BPB) (n = 30). GA was standardized to include induction with propofol and alfen-tanil and maintenance with desflurane in an oxygen/nitrous oxide mixture. BPB was performed using an axillary perivascular appro-ach, and 1.5% lidocaine 20 ml with epinephrine (1 : 200,000) and 0.5% levobupivacaine 20 ml were injected. Pain scores and num-bers of times pushing the patient-controlled analgesia (PCA) button were measured preoperatively and at 2, 6, and 24 hours after the end of surgery. On the first day after the operation, one of our researchers visited the patients to document their opinions of their anesthetic experiences and their satisfaction scores.
Results: Group BPB had lower visual analog scale scores at 2 hours and 6 hours postoperatively. Numbers of times pushing the PCA button was also lower in Group BPB within the first 2 hours and between 2?6 hours postoperatively. However, patient satisfac-tion scores were not statistically different between the two groups (84 ± 11 vs. 88 ± 12, P = 0.177).
Conclusions: BPB provided superior analgesia after upper limb surgery compared to GA, but for a complete understanding of patients’ satisfaction, detailed consideration of factors such as sedation would be necessary.
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KEYWORD
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Axillary brachial plexus block, General anesthesia, Pain, Sedation
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