Continuous blocking of the brachial plexus. Repercussions in the subsequent post-surgery period

Abstract

Our objective was evaluating the subsequent post-surgery period in patients with traumatic surgical lesion of the upper limb that received two methods anesthesia-analgesia. Methodological design: 240 patients, ASA I-II-III, divided into two equal groups: Group G: General endotracheal anesthesia plus fentanyl and analgesia with dypirone 1, 2 IM every 6 hours.Group B: Regional anesthesia by BCPB with 100 mg of bupivacaine and regional analgesia with local anesthetic every 6 hours. Among the obtained results, hematoma was present in 7 (5.8 %) group G patients and in 2 (1.7 %) group B patients. The compartmental syndrome showed in 6 (5 %) and 1 (0.8 %) groups G and B patients respectively. Sepsis occurred in 9 (7.5 %) group G patients and only in 1 (0.8 %) group B patient (p = 0.009). Blisters and complex regional pain syndrome presented in 4 (3.3 %) and 2 (1.7 %) group G patients, the first being statistically significant (p = 0.04). These complications were 7 times more frequent in group G patients. There were 22 (18.3 %) patients complicated in the group G and 3 (2.5 %) in the group B (p=0,000). Precocious rehabilitation took place in 28 (23.3 %) group G patients and 107 (89.2 %) group B patients (p=0,000). The patients of the group G needed 6.3 hospitalization days per patient and the group B patients 4.8 days, inferring a higher economical expense per staying and resources to treat the complications. In the subsequent post-surgery period, the patients who received the regional anesthesia-analgesia method by BCPB had a faster precocious rehabilitation with fewer incidences of subsequent surgical complications and hospital staying time.