The Efficacy of Axillary Block for Urgency Upper Extremity Orthopedic Procedures in Pediatric Patients in Udonthani Hospital

Abstract

Background: General anesthesia for emergency/urgency upper extremity orthopedic procedures  in pediatric patient may risks of  increase pulmonary aspiration and airway complications. Axillary block is simple  to perform and with minimal complications, which may be used as a sole technique or combined with sedation for these patients and has benefit in postoperative pain control and minimized complication of general anesthesia.

Objective: To study the efficacy and complications of axillary block anesthesia in  emergency upper extremity orthopedic procedures  in pediatric patients.

Design: A prospective descriptive study

Setting: Udonthani Hospital, Udonthani, Thailand.

Methods : A total of 112 pediatric patients  who underwent  emergency/urgency surgical procedures to the distal humerus, elbow , forearm and hand between July-December 2007. A total of 112 of pediatric patients aged between 1 to 14 year-old had axillary block  (perivascular/transarterial technique).

Analysis: Descriptive analysis.

Results: Ninety percent had adequate anesthesia and 42.8% need premedication for coorperation .Only 0.9% had been  changed anesthetic technique to general anesthesia due to fail block. About 8.9 % had inadequate anesthesia and need narcotic supplement during operation. In  PACU 1.8% of patients need narcotic for pain treatment. Over all 2.7% of patients have complication; nausea/vomiting 1.8% and shivering 0.9% and all of them response to treatment. No any local anesthetic toxicity or neurologic damage was found.

Conclusion: The axillary block may be successfully used for urgency surgical procedures in upper extremity from distal humerus in pediatric patients. This technique is sufficiency for post-operative pain control in PACU and can avoid complications from general anesthesia.

Keywords : efficacy, axillary block, pediatric patients, upper extremity.