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Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
ISSN: 1995-7262
Vol. 26, No. 3, 2014, pp. 90-92
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Bioline Code: mm14018
Full paper language: English
Document type: Research Article
Document available free of charge
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Malawi Medical Journal, Vol. 26, No. 3, 2014, pp. 90-92
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Orthopaedic anaesthesia for upper extremity procedures in a Nigerian hospital
Rukewe, A.; Fatiregun, A. & Alonge, T. O.
Abstract
Background
General anaesthesia and regional anaesthesia have been used successfully
for upper extremity orthopaedic procedures. Despite the advantages of
regional anaesthesia, there is low utilisation in Nigeria. In this study, we
assessed the types of anaesthesia employed for upper extremity surgeries
in our centre.
Methods
After obtaining approval from the institutional ethics committee, all
the patients who had upper extremity surgeries from 1 January 2011 to
31 December 2012 were included in this review. Both prospective and
retrospective data were gathered. The choice of anaesthesia was at the
discretion of the attending anaesthetist.
Results
A total of 226 patients with a male-to-female ratio of 1.6:1 and median
age of 35.0 (range 2 – 89) years, had orthopaedic upper extremity
procedures during the study period. Sixty-three cases (27.9%) had general
anaesthesia, 5 (2.2%) combined regional and general anaesthesia while
158 (69.9%) had regional blocks. The regional blocks comprised 145
(89%) different approaches to the brachial plexus and 18 (11%) local
anaesthetic infiltrations. The arm was the site mostly operated upon; while
supraclavicular and axillary brachial plexus blocks were performed in equal
amounts. In 14 (6.2%) patients, brachial plexus blocks were performed with
spinal anaesthesia because of concomitant iliac crest bone grafts. While
the duration of surgery did not differ significantly, regional anaesthesia
provided a significantly longer duration of anaesthesia than general
anaesthesia (251 ± 70.8 min versus 141.3 ± 65.5 min; p = 0.0000001).
Conclusion
There is a high use of regional anaesthesia for upper extremity orthopaedic
surgeries in our centre, which is a positive development in a resource
limited setting.
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