Audit on documentation completeness after regional nerve blocks at University of Gondar referral hospital, 2018 (original) (raw)
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Clinical guidelines for the practice of peripheral nerve blocks in the adult
Acta anaesthesiologica Belgica, 2013
These guidelines, made by BARA, are, like the "Safety First Guidelines" of the SARB, clinical recomendations for a good and safe practice when performing peripheral nerve blocks (PNB). These recommendations were made according to the most recent literature and experts opinion and are therefore prone to changes due to evolution of literature. The guidelines deal with "Informed Consent", preoperative visit, monitoring, equipment and the PNB procedure itself regardless of using ultrasound or neurostimultion or both. Advise is given when combining a PNB with general anesthesia and when a catheter technique is used.
Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system
British journal of anaesthesia, 2015
Although wrong-site surgery has garnered extensive scrutiny, the incidence of wrong-site blocks remains unknown. Our study thus sought to quantify the incidence of wrong-site blocks and examine some of their associated risk factors in our multihospital health-care system. Using quality-improvement and billing data, we quantified the total number of blocks and wrong-site blocks occurring between July 1, 2002 and June 30, 2012 within the University of Pittsburgh Medical Center Health System. The incidence of wrong-site block was determined by block type, hospital, and type of service involved in performing the block. The incidence of wrong-site block was compared with that of wrong-site surgery. Fisher's exact tests were performed to determine associations between the incidence of wrong-site block and any of the aforementioned variables. A root-cause analysis was performed to determine the source of wrong-site blocks after the implementation of a timeout policy. Of the 85 915 pati...
2013
A survey of anaesthesiologists' practicing in Kenya on knowledge attitude and practice towards the use of Peripheral Nerve Blocks DECLARATION 1. I understand what Plagiarism is and I am aware of the University's policy in this regard 2. I declare that this __________________ (Thesis, project, essay, assignment, paper, report, etc) is my original work and has not been submitted elsewhere for examination, award of a degree or publication. Where other people's work or my own work has been used, this has properly been acknowledged and referenced in accordance with the University of Nairobi's requirements. 3. I have not sought or used the services of any professional agencies to produce this work. 4. I have not allowed, and shall not allow anyone to copy my work with the intention of passing it off as his/her own work. 5. I understand that any false claim in respect of this work shall result in disciplinary action, in accordance with University Plagiarism Policy.
Training of residents in peripheral nerve blocks during anesthesiology residency
Journal of Clinical Anesthesia, 2002
Study Objective: To survey American anesthesiology residency program directors to determine the availability and extent of training in peripheral nerve block techniques. Design: Survey questionnaire was mailed and faxed to 132 American anesthesiology residency program directors and followed up 4 weeks later with another mailing to nonresponders. Setting: University medical center. Measurements and Main Results: Of the 132 American anesthesiology residency program directors surveyed, 69 (52%) responded. Of the responders, 40 (58%) offered a specific peripheral nerve block rotation. The rotation was of 1 month's duration in 61% of these programs. Formal instruction was administered during the rotation in 69%. The regional instruction approach consisted of a nerve stimulator (98%), paresthesia (75%), and transarterial (85%). Multimedia, mannequins, and cadaver dissection were used infrequently (13-25%). During the rotation, residents performed a variety of blocks, but the number of each block varied from 2 (supraclavicular) to 10 (axillary). These blocks were performed in the operating room in 48% of programs. Finally, in the programs with a specific peripheral nerve block rotation, residents were evaluated. Conclusions: Specific peripheral nerve block rotations are not always included in anesthesiology residents' curriculum. In addition, residents in programs with a specific nerve block rotation are exposed to a greater number of peripheral nerve block techniques than those who do not have such a rotation included in their curriculum.
Safety and follow-up systems after ambulatory peripheral nerve block: a narrative review
Acta Anaesthesiologica Belgica, 2022
Background: Ambulatory surgery has grown during the last decades, and Peripheral Nerve Blocks (PNB) are widely used for perioperative and postoperative pain management. Follow-up is required during all stages of recovery to assess adverse events. Patients are usually discharged before PNB effects have worn off, but nextday follow-up allows the detection of adverse events. Digital systems are used for different follow-up services, but knowledge is lacking in their use for PNB follow-up. Objective: This narrative review describes PNB-related adverse events and current ambulatory surgery follow-up practices during all recovery stages. Furthermore, this review will evaluate the methods used for PNB follow-up. Methods: A literature search was performed using SCOPUS, Embase, and MEDLINE databases from the earliest record to 01-03-2022. Articles were included if they assessed PNB-related adverse events, follow-up services for ambulatory surgery and PNBs, and outcomes for ambulatory surgery and PNBs. Articles were excluded if they studied non-surgical patients, were inaccessible or contained comments or letters. Results: 67 articles were included after screening. Three postoperative phases are described. Phase 1 encompasses the post-anesthetic care unit (PACU) stay. Phase 2 covers the time from PACU discharge to hospital discharge, and phase 3 starts after hospital discharge. The review shows that follow-up is provided adequately during the postoperative phases 1 and 2, but phase 3 lacks a proper follow-up. Possible complications for PNBs include pain, nausea and vomiting, dyspnea, neurological damage, and infection should be routinely evaluated postoperatively, preferably the day after discharge. Postoperative follow-up is often provided using a telephone call, but a lost-to-follow-up rate of up to 50% is described. Follow-up rates can be improved using digital follow-up systems, including automatic text messages and applications. Video consultations can be used to evaluate these complications. Conclusion: PNB postoperative follow-up after discharge is not well-provided. Telephone follow-up of PNB has a poor response. Digital follow-up systems, like automatic text messages and applications, can increase follow-up rates. Therefore, we recommend application-based follow-up systems. However, additional studies should evaluate the effect on patient outcomes.
Safety and Efficacy of Rescue Nerve Blocks
Journal of Clinical and Biomedical Investigation, 2022
Background: The overall incidence of complications following peripheral nerve blocks is very low. Peripheral nerve blocks performed under ultrasound guidance are widely thought to present a lower risk to direct needle trauma than paresthesia and nerve stimulation techniques and have been shown to decrease opioid consumption by providing analgesia directly to the site of injury. Currently, when a nerve block fails altogether or provides inadequate analgesia, pain and opioid consumption increases which in turn decrease patient satisfaction and increases healthcare costs. Concerns remain whether the benefits of opioid reduction outweigh the risk of inadvertent needle trauma and other potential complications when performing a nerve block replacement, or ‘rescue block’. Objective: Examine whether performing a rescue peripheral nerve block provides adequate analgesia to elicit a decrease in opioid consumption. Analyze the incidence of nerve injury following ultrasound-guided ‘rescue’ cont...
JPMA. The Journal of the Pakistan Medical Association, 2021
OBJECTIVE To assess the safety and effectiveness of peripheral nerve blocks using ultrasound. METHODS The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all patients who received peripheral nerve blocks as part of anaesthesia care between January 2015 and January 2017. The data included outcomes of peripheral nerve block effectiveness, complications and limb conditions after the block. Peripheral nerve block effectiveness was assessed by monitoring pain scores at rest and on movement, and the requirement of co-analgesia. Complications, like numbness, motor block, metallic taste, hypotension and respiratory depression, were also assessed. Data was analysed using SPSS 19. RESULTS There were 299 patients who received ultrasound-guided peripheral nerve blocks. The overall mean age was 44.57±16.64 years. Of the total, 140 (47%) received transversus abdominis plane block, followed by supraclavicular block 49(16.7%). The most common co...