General anesthesia versus ultrasound-guided axillary block for ambulatory hand surgery: randomized prospective study

Abstract

BackgroundIn upper limb surgery, both axillary brachial plexus block (ABPB) and general anesthesia (GA) have been widely used. ABPB is one of the most popular and widely used procedures for brachial plexus blocks, as well as for achieving upper limb regional anesthesia.The aim of the study was to compare between both anesthetic techniques for ambulatory hand surgery regarding their effects on postoperative pain as primary outcome and postoperative nausea and vomiting and patient satisfaction and postoperative sleep disturbances as secondary outcomes.ResultsWe reviewed data from 40 patients for the primary outcome and found that group A (had general anesthesia) had a statistically significant higher postoperative VAS score than group B (got ultrasound guided axillary block), (P-value 0.05). In terms of secondary outcomes, postoperative nausea and vomiting were significantly higher in group A patients (P-value 0.001), and patient satisfaction was significantly higher in group B patients compared to group A patients (P-value 0.001). Furthermore, the Pittsburgh quality index (PSQI) for postoperative sleep disruptions was considerably higher in group A than in group B at 24 h postoperatively and at the first and second weeks postoperatively (P-value 0.001). Statistically, there is no difference between the two groups in the third week and one month after surgery.ConclusionsWhen compared to general anesthesia, ultrasound-guided axillary brachial plexus block offered good anesthesia, great analgesia, and a better postoperative sleep result after hand surgery.