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Risk factors for insufficient ultrasound-guided supraclavicular brachial plexus block
Shingo Abe1, Hiroki Kondo2, Yohei Tomiyama2
1Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan. a.shingo13@gmail.com.
Journal of Experimental Orthopaedics
|April 20, 2023
Summary
Obesity, elbow surgery, and high preoperative systolic blood pressure (over 170 mmHg) predict the need for additional local anesthesia during ultrasound-guided supraclavicular brachial plexus blocks (SCBPB). This helps optimize anesthesia management for upper limb surgeries.
Area of Science:
- Anesthesiology
- Surgical Procedures
- Medical Imaging
Background:
- Ultrasound-guided supraclavicular brachial plexus block (SCBPB) is a common technique for upper limb anesthesia.
- Some patients require additional local anesthesia during SCBPB procedures.
Purpose of the Study:
- To identify risk factors associated with the need for additional local anesthetic injections during SCBPB.
- To improve anesthetic management and patient outcomes in upper limb surgery.
Main Methods:
- A cohort of 269 patients undergoing ultrasound-guided SCBPB was analyzed.
- Propensity score matching was used to compare patients who required additional anesthesia versus those who did not.
- Risk factors including BMI, preoperative blood pressure, surgical site, and patient comorbidities were assessed.
Main Results:
- 15.2% of patients required additional intraoperative local anesthesia.
- Elbow surgery was associated with the highest prevalence (41%) of additional anesthesia needs.
- High body mass index (obesity) and high systolic blood pressure (>170 mmHg) were significant predictors.
Conclusions:
- Obesity, elbow surgery, and elevated preoperative systolic blood pressure are key predictors for requiring additional local anesthesia during SCBPB.
- These findings can help surgeons anticipate and manage anesthesia needs more effectively.
- Systolic blood pressure over 170 mmHg demonstrated high specificity in predicting the need for supplemental anesthesia.
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