A comparison of general anesthesia versus axillary brachial plexus block for hand and wrist surgery in the view of patient satisfaction

Lee, Mi Geum; Kim, Hong Soon; Lee, Dong Chul; Jung, Wol Seon; Chang, Young Jin

Clinical Research

Spinal Pain

Anesthesia and Pain Medicine 2014;9(1):19-23.
Published online January 30, 2014.

A comparison of general anesthesia versus axillary brachial plexus block for hand and wrist surgery in the view of patient satisfaction

Mi Geum Lee, Hong Soon Kim, Dong Chul Lee, Wol Seon Jung, Young Jin Chang

Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science Gil Medical Center, Incheon, Korea. khs@gilhospital.com

Received: 24 September 2013 • Revised: 4 November 2013

Abstract

BACKGROUND
We evaluated whether the analgesic superiority of regional block over general anesthesia improves patient satisfaction.
METHODS
Patients were anesthetized with either general anesthesia (GA) (n = 30) or axillary brachial plexus block (BPB) (n = 30). GA was standardized to include induction with propofol and alfentanil and maintenance with desflurane in an oxygen/nitrous oxide mixture. BPB was performed using an axillary perivascular approach, and 1.5% lidocaine 20 ml with epinephrine (1 : 200,000) and 0.5% levobupivacaine 20 ml were injected. Pain scores and numbers 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 satisfaction 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.

Key Words: Axillary brachial plexus block, General anesthesia, Pain, Sedation