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Brachial plexus anesthesia compared to general anesthesia when a block room is available

[L’anesthésie du plexus brachial comparée à l’anesthésie générale quand une salle de bloc est disponible]

From the Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada.

Address correspondence to: Dr. Kevin P.J. Armstrong, Department of Anesthesia and Perioperative Medicine, University of Western Ontario, St. Joseph’s Health Care London, 268 Grosvenor St., London, Ontario N6A 2V4, Canada. Phone: 519-646-6100; Fax: 519-646-6116; E-mail: Kevin.Armstrong2{at}sympatico.ca

Purpose: Regional anesthesia is often felt to be beneficial to patient care but detrimental to operating room (OR) efficiency. In this report we compare how a block room (BR) affects OR time (ORT) utilization for brachial plexus anesthesia (BPA) in a busy upper limb practice. We also compare how anesthetic technique, BPA or general anesthesia (GA), impacts on the time to recovery and discharge in patients having outpatient upper limb surgery.

Methods: With the Ethics Committee’s approval, a prospective study using hospital databases was undertaken. All patients presenting for surgery on the upper limb between November 1999 and April 2000 were eligible for analysis. A comparison was made of the various time intervals that comprise a patient’s hospital stay for either GA or BPA. Demographic data (ASA, age, outpatient status), and location of BPA were analyzed.

Results: Use of the BR for BPA significantly reduced the pre-procedure anesthesia ORT when compared to BPA done in the OR (11.4 vs 32.9 min, P < 0.05; GA pre-procedure time was 17.8 min). In the ambulatory patient, BPA alone reduced post procedure anesthesia ORT, postanesthetic care unit, surgical day care unit, and total hospital times when compared to those receiving GA. On average those receiving a BPA spent 1.5 hr less in hospital (P < 0.01). Additionally, fewer admissions (2.4 vs 5.4%) occurred in the BPA group.

Conclusion: The use of a BR reduces the anesthesia ORT associated with BPA. Secondly, BPA improves the recovery time phase of outpatients undergoing surgery on the upper limb.

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