EPIDEMIOLOGY AND COMPLICATIONS OFPERIPHERAL NERVE BLOCKS IN ORTHOPEDICS AND TRAUMATOLOGY : RABAT MILITARYHOSPITAL EXPERIENCE

Abstract

In recent years, Peripheral Nerve Blocks (PNB) have undergone a significant development due to the simplicity of management of patients under peripheral nerve blocks and especially the quality of postoperative analgesia. This study aims at reviewing the epidemiology and complications of Peripheral nerve blocks. We conducted a prospective surveillance study including all patients who had undergone surgery under peripheral nerve blocks for anesthesia or analgesia in the Trauma Department of the Military Hospital Mohammed V of Rabat over four (4) years. We recorded demographic characteristics, ASA class, effects of puncture, time of performing peripheral nerve blocks, failure, requirement for further block, perioperative and postoperative complications and theirmanagement. One thousand four hundred and twelve (1412) patients underwent nerve blocks during the study period, representing 49% of anesthetic activity in Trauma Department. The mean age is 35 years old. For 85% of patients, the indication of peripheral nerve blocks was advised for anesthesia and 15% PNBwere purely for analgesia. The most performed anesthetic nerve blocks were the infraclavicular blocks followed by blocks at the humeral canal. For analgesia, the ilio-facial and femoral blocks are the most performed. Minor complications are dominated by vascular punctures and paresthesia. As far asmajor complications are concerned, we noticed four (4) cases of convulsions and two (2) cases of neuropathies. Peripheral locoregional anesthesia is an effective and safe method for anesthesia and analgesia. Minor incidents are frequent, serious complications are possible. Their prevention is achieved through compliance to rules on peripheral nerve blocks performance, contraindication, benefit and risk analysis of each block and ultrasound skills.