Postoperative neurological complications after brachial plexus block: a retrospective study conducted at a teaching hospital.

Szczegóły
Abstrakt

Tytuł:: Postoperative neurological complications after brachial plexus block: a retrospective study conducted at a teaching hospital.
Autorzy:: Oliver-Fornies P; Department of Anesthesiology, Critical Care and Pain Medicine, Lozano Blesa University Clinical Hospital, Avda. San Juan Bosco, 15, 50009, Zaragoza, Spain. .; Investigator of GIIS083, Aragon Institute for Health Research (IISAragon), Zaragoza, Spain. .; Morphological Madrid Research Center (MoMaRC), Ultradissection Spain EchoTraining School, Madrid, Spain. .
Ortega Lahuerta JP; Division of Regional Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Miguel Servet University Hospital, Zaragoza, Spain.
Gomez Gomez R; Division of Regional Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Miguel Servet University Hospital, Zaragoza, Spain.
Gonzalo Pellicer I; Division of Regional Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Miguel Servet University Hospital, Zaragoza, Spain.
Herranz Andres P; Division of Regional Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Miguel Servet University Hospital, Zaragoza, Spain.
Sancho-Saldana A; Department of Neurology, Arnau Villanova University Hospital, Lerida, Spain.
Źródło:: Journal of anesthesia [J Anesth] 2021 Dec; Vol. 35 (6), pp. 844-853. Date of Electronic Publication: 2021 Aug 25.
Typ publikacji:: Journal Article; Observational Study
Język:: English
Imprint Name(s):: Publication: Tokyo : Springer International for the Japan Society of Anesthesiology
Original Publication: [Tokyo] : Japan Society of Anesthesiology, [1987-
MeSH Terms:: Brachial Plexus*/diagnostic imaging
Brachial Plexus Block*/adverse effects
Anesthetics, Local ; Hospitals, Teaching ; Humans ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Ultrasonography, Interventional
References:: Allegri M, Bugada D, Grossi P, Manassero A, Pinciroli LR, Zadra N, Fanelli G, Zarcone A, Cataldo R, Danelli G, Borghi B. Italian registry of complications associated with regional anesthesia (RICALOR). An incidence analysis from a prospective clinical survey. Minerva Anestesiol. 2016;82:392–402. (PMID: 26584187)
Orebaugh SL, Kentor ML, Williams BA. Adverse outcomes associated with nerve stimulator-guided and ultrasound-guided peripheral nerve blocks by supervised trainees: update of a single-site database. Reg Anesth Pain Med. 2012;37:577–82. (PMID: 10.1097/AAP.0b013e318263d396)
Barrington MJ, Watts SA, Gledhill SR, Thomas RD, Said SA, Snyder GL, Tay VS, Jamrozik K. Preliminary results of the Australasian regional anaesthesia collaboration: a prospective audit of more than 7000 peripheral nerve and plexus blocks for neurologic and other complications. Reg Anesth Pain Med. 2009;34:534–41. (PMID: 10.1097/AAP.0b013e3181ae72e8)
Neal JM, Barrington MJ, Brull R, Hadzic A, Hebl JR, Horlocker TT, Huntoon MA, Kopp SL, Rathmell JP, Watson JC. The Second ASRA Practice Advisory on neurologic complications associated with regional anesthesia and pain medicine. Reg Anesth Pain Med. 2015;40:401–30. (PMID: 10.1097/AAP.0000000000000286)
Gauss A, Tugtekin I, Georgieff M, Dinse-Lambracht A, Keipke D, Gorsewski G. Incidence of clinically symptomatic pneumothorax in ultrasound-guided infraclavicular and supraclavicular brachial plexus block. Anaesthesia. 2014;69:327–36. (PMID: 10.1111/anae.12586)
Ecoffey C, Oger E, Marchand-maillet F, Cimino Y. Complications associated with 27 031 ultrasound-guided axillary brachial plexus blocks A web-based survey of 36 French centres. Eur J Anaesthesiol. 2014;31:606–10. (PMID: 10.1097/EJA.0000000000000063)
Barrington MJ, Kluger R. Ultrasound guidance reduces the risk of local anesthetic systemic toxicity following peripheral nerve blockade. Reg Anesth Pain Med. 2013;38:289–97. (PMID: 10.1097/AAP.0b013e318292669b)
Lecours M, Levesque S, Dion N, Nadeau M, Dionne A, Turgeon A. Complications of single-injection ultrasound-guided infraclavicular block: a cohort study. Can J Anesth. 2013;60:244–52. (PMID: 10.1007/s12630-012-9825-2)
Singh A, Kelly C, Brien TO, Wilson J, Warner JJP. Ultrasound-guided interscalene block anesthesia a prospective study of 1319 patients. J bone Jt Surg. 2012;94:2040–6. (PMID: 10.2106/JBJS.K.01418)
Sites BD, Taenzer AH, Herrick MD, Gilloon C, Antonakakis J, Richins J, Beach ML. Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks: an analysis from a prospective clinical registry. Reg Anesth Pain Med. 2012;37:478–82. (PMID: 10.1097/AAP.0b013e31825cb3d6)
Liu SS, Gordon MA, Shaw PM, Wilfred S, Shetty T, YaDeau JT. A prospective clinical registry of ultrasound-guided regional anesthesia for ambulatory shoulder surgery. Anesth Analg. 2010;111:617–23. (PMID: 10.1213/ANE.0b013e3181ea5f5d)
Fredrickson MJ, Kilfoyle DH. Neurological complication analysis of 1000 ultrasound guided peripheral nerve blocks for elective orthopaedic surgery: a prospective study. Anaesthesia. 2009;64:836–44. (PMID: 10.1111/j.1365-2044.2009.05938.x)
Hebl JR. Ultrasound-guided Regional Anesthesia and the Prevention of Neurologic Injury. Anesthesiology. 2008;108:186–8. (PMID: 10.1097/01.anes.0000299835.04104.02)
Sondekoppam RV, Tsui BCH. Factors associated with risk of neurologic complications after peripheral nerve blocks: a systematic review. Anesth Analg. 2017;124:645–60. (PMID: 10.1213/ANE.0000000000001804)
Brull R, Hadzic A, Reina MA, Barrington MJ. Pathophysiology and etiology of nerve injury following peripheral nerve blockade. Reg Anesth Pain Med. 2015;40:479–90. (PMID: 10.1097/AAP.0000000000000125)
European Parliament and of the Council. Directive 2001/20/EC of the European Parliament and of the Council of 4 April 2001 on the approximation of the laws, regulations, and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of [Internet]. Off. J. Eur. Communities. [cited 2020 Nov 15]. https://ec.europa.eu/health/sites/health/files/files/eudralex/vol-1/dir_2001_20/dir_2001_20_en.pdf.
WMA Declaration of Helsinki—Ethical principles for medical research involving human subjects [Internet]. World Med. Assoc. [cited 2020 Nov 15]. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/.
Head of state. Govern of Spain. Organic Law 3/2018. Protection of Personal Data and guarantee of digital rights [Internet]. Off. State Gaz. [cited 2020 Nov 15]. https://www.boe.es/boe/dias/2018/12/06/pdfs/BOE-A-2018-16673.pdf.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:1623–7.
Hadzic A (2007) Textbook of regional anesthesia and acute pain management. 1 . Hadzic A (ed) McGrawHill Education, New York.
Lam KK, Soneji N, Katzberg H, Xu L, Chin KJ, Prasad A, Chan V, Niazi A, Perlas A. Incidence and etiology of postoperative neurological symptoms after peripheral nerve block: a retrospective cohort study. Reg Anesth Pain Med. 2020;45:495–504. (PMID: 10.1136/rapm-2020-101407)
Staff NP. Postsurgical neuropathy: a descriptive review. Mayo Clin Proc. 2020;95:355–69. (PMID: 10.1016/j.mayocp.2019.05.038)
Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007;8:326–31. (PMID: 10.1111/j.1526-4637.2006.00169.x)
U.S. Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 [Internet]. [cited 2020 Nov 15]. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_8.5x11.pdf.
Bilbao Ares A, Sabaté A, Porteiro L, Ibáñez B, Koo M, Pi A (2013) Complicaciones neurológicas asociadas a bloqueos interescalénico y supraclavicular guiados con ecografía en cirugía electiva de hombro y extremidad superior Estudio observacional prospectivo en un hospital universitario. Rev Esp Anestesiol Reanim 60:384–391.
Gaucher A, Lacroix C, Frasca D, Mimoz O, Debaene B. Pratique de l’anesthésie locorégionale périphérique par les internes en anesthésie-réanimation en région Poitou-Charentes. Ann Fr Anesth Reanim. 2013;32:756–9. (PMID: 10.1016/j.annfar.2013.07.811)
Sites B, Barrington M, Davis M. Using an international clinical registry of regional anesthesia to identify targets for quality improvement. Reg Anesth Pain Med. 2014;39:4887–5495.
Dwyer T, Henry PDG, Cholvisudhi P, Chan VWS, Theodoropoulos JS, Brull R. Neurological complications related to elective orthopedic surgery: part 1: common shoulder and elbow procedures. Reg Anesth Pain Med. 2015;40:431–42. (PMID: 10.1097/AAP.0000000000000178)
Candido KD, Sukhani R, Doty R, Nader A, Kendall MC, Yaghmour E, Kataria TC, McCarthy R. Neurologic sequelae after interscalene brachial plexus block for shoulder/upper arm surgery: the association of patient, anesthetic, and surgical factors to the incidence and clinical course. Anesth Analg. 2005;100:1489–95. (PMID: 10.1213/01.ANE.0000148696.11814.9F)
Gasparotti R, Padua L, Briani C, Lauria G. New technologies for the assessment of neuropathies. Nat Rev Neurol Nature Publ Group. 2017;13:203–16. (PMID: 10.1038/nrneurol.2017.31)
Staff NP, Engelstad J, Klein CJ, Amrami KK, Spinner RJ, Dyck PJ, Warner MA, Warner ME, B.Dyck PJ. Post-surgical inflammatory neuropathy. Brain. 2010;133:2866–80. (PMID: 10.1093/brain/awq252)
Holbrook HS, Parker BR. Peripheral nerve injury following interscalene blocks: a systematic review to guide orthopedic surgeons. Orthopedics. 2018;41:E598–606. (PMID: 10.3928/01477447-20180815-04)
Casas-Arroyave F, Ramírez-Mendoza E, Ocampo-Agudelo A. Complications associated to three brachial plexus blocking techniques: systematic review and meta-analysis. Rev Esp Anestesiol. 2021;68:392–407. (PMID: 10.1016/j.redar.2020.10.005)
Tanijima M, Takechi K, Nakanishi K, Yorozuya T. Adverse events associated with continuous interscalene block administered using the catheter-over-needle method: a retrospective analysis. BMC Anesthesiol. 2019;19:1–5. (PMID: 10.1186/s12871-019-0873-9)
Bomberg H, Wetjen L, Wagenpfeil S, Schöpe J, Kessler P, Wulf H, Wiesmann T, Standl T, Gottschalk A, Döffert J, Hering W, Birnbaum J, Kutter B, Winckelmann J, Liebl-Biereige S, Meissner W, Vicent O, Koch T, Bürkle H, Sessler DI, Volk T. Risks and benefits of ultrasound, nerve stimulation, and their combination for guiding peripheral nerve blocks: a retrospective registry analysis. Anesth Analg. 2018;127:1035–43. (PMID: 10.1213/ANE.0000000000003480)
Heinonen JA, Litonius E, Pitkänen M, Rosenberg PH. Incidence of severe local anaesthetic toxicity and adoption of lipid rescue in Finnish anaesthesia departments in 2011–2013. Acta Anaesthesiol Scand. 2015;59:1032–7. (PMID: 10.1111/aas.12545)
Orebaugh SL, Williams BA, Kentor ML, Bolland MA, Mosier SK, Nowak TP. Interscalene block using ultrasound guidance: Impact of experience on resident performance. Acta Anaesthesiol Scand. 2009;53:1268–74. (PMID: 10.1111/j.1399-6576.2009.02048.x)
Neal JM. Ultrasound-guided regional anesthesia and patient safety: update of an evidence-based analysis. Reg Anesth Pain Med. 2016;41:195–204. (PMID: 10.1097/AAP.0000000000000295)
Kwofie K, Uppal V. Wrong-site nerve blocks: evidence-review and prevention strategies. Curr Opin Anaesthesiol. 2020;33:698–703. (PMID: 10.1097/ACO.0000000000000912)
Henshaw DS, Turner JD, Dobson SW, Douglas Jaffe J, Wells Reynolds J, Edwards CJ, Weller RS. Preprocedural checklist for regional anesthesia: Impact on the incidence of wrong site nerve blockade (an 8-year perspective). Reg Anesth Pain Med. 2019;44:201–5. (PMID: 10.1136/rapm-2018-000033)
Deutsch ES, Yonash RA, Martin DE, Atkins JH, Arnold TV, Hunt CM. Wrong-site nerve blocks: a systematic literature review to guide principles for prevention. J Clin Anesth. 2018;46:101–11. (PMID: 10.1016/j.jclinane.2017.12.008)
Sites BD, Chan VW, Neal JM, Weller R, Grau T, Koscielniak-Nielsen ZJ, Ivani G. The American Society of Regional Anesthesia and Pain Medicine and the European Society of Regional Anaesthesia and Pain Therapy joint committee recommendations for education and training in ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2009;34:40–6. (PMID: 10.1097/AAP.0b013e3181926779)
Neal JM, Brull R, Horn JL, Liu SS, McCartney CJL, Perlas A, Salinas FV, Tsui BCH. The second American society of regional anesthesia and pain medicine evidence-based medicine assessment of ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2016;41:181–94. (PMID: 10.1097/AAP.0000000000000331)
Contributed Indexing:: Keywords: Brachial plexus block; Postoperative complications; Regional anaesthesia; Training; Ultrasonography
Molecular Sequence:: ClinicalTrials.gov NCT04451642
Substance Nomenclature:: 0 (Anesthetics, Local)
Entry Date(s):: Date Created: 20210825 Date Completed: 20211224 Latest Revision: 20221202
Update Code:: 20240104
DOI:: 10.1007/s00540-021-02989-7
PMID:: 34432155
: Czasopismo naukowe

Pełny tekst

Purpose: Serious complications after ultrasound-guided regional anaesthesia can be devastating for the patient. The pathogenesis of postoperative neurological complications (PONC) is multifactorial and includes mechanical, vascular and chemical factors besides the nerve puncture itself. The primary aim of this study was to assess the incidence of PONC after brachial plexus block (BPB).
Methods: This is an observational retrospective single-centre study conducted at the regional anaesthesia unit of a teaching hospital. All BPBs performed from January 2011 to November 2019 were included. The outcomes analysed were the incidence, aetiology and diagnosis of PONCs and the incidence of other postoperative complications such as local anaesthetic systemic toxicity (LAST), pneumothorax, wrong-side block, etc. The performance of trainees and experienced anaesthesiologists was compared across all the outcomes.
Results: From a total of 5340 BPBs included, 15 cases developed PONC, yielding a rate of 2.81:1000 (95% CI 1.70-4.63). Thirteen patients underwent neurophysiological exams which confirmed nine neuropathies. The rate of PONCs for supervised trainees was 1.80:1000 (95% CI 0.701-4.62), not statistically different from that of experienced anaesthesiologists (p = 0.241). Three cases were considered to present with a PONC probably related to BPB [0.562:1,00 (95% CI 0.191-1.65)]. The incidence of long-term PONCs was 1.12:1000 (95% CI 0.515-2.45). Such complications proved irreversible in 2 cases. The incidences of LAST, pneumothorax and other complications observed were 0.749:1000 (95% CI 0.291-1.92), 0.187:1000 (95% CI 0.0331-1.06) and 4.31:1000 (95% CI 2.87-6.46), respectively.
Conclusions: This survey suggests that complications after ultrasound-guided BPB, including blocks performed by trainees, are uncommon.
Trial Registration: Clinicaltrials.gov ID: NCT04451642.
(© 2021. Japanese Society of Anesthesiologists.)

Informacja