Postoperative Analgesia Following Sciatic Nerve Blockade Administered by Nurse Anesthetists Supervised by Regional Anesthesia Faculty in an Academic Hospital
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 10, Issue 6
Abstract
Introduction: Assessment of expertise in regional anesthesia techniques is traditionally based upon quota fulfillment of procedures during training. Validation of practitioner proficiency in performing procedures in surgical specialties has moved from simple measurement of technical skills to evaluation of global patient outcomes. Complete absence of pain as a result of nerve blockade is the most important clinical endpoint but patient, technical and procedural factors influence results. The purpose of this study was to measure the postoperative pain scores and associated analgesic medication requirements for patients administered sciatic nerve blockade by nurse anesthetists and determine patient or procedural factors that influenced this outcome. Methods: Either nerve stimulator or ultrasound guided sciatic nerve blockade was administered by nurse anesthetists under the supervision of regional anesthesia faculty. Patient demographic data that was collected included gender, body mass index, surgical procedure, and pre-existing chronic pain with associated opioid use. Patient self-reported pain scores and opioid analgesic dosages in the preoperative, intraoperative, immediate postoperative and 24 hour post procedure intervals were recorded. Results: 22 nurse anesthetists administered sciatic nerve blockade to 48 patients during a 36 month interval. Transition from a nerve stimulator to ultrasound guided sciatic nerve block technique resulted in lower mean pain scores. Patients reporting chronic opioid use were observed to have elevated perioperative opioid analgesic requirements and pain scores compared to opioid naïve patients. Conclusion: Effective analgesia is a prime measure for assessing expertise in regional anesthesia and continuous evaluation of this outcome in everyday practice is proposed.
Authors and Affiliations
L. Lollo, A. Stogicza
Keywords
Related Articles
- EP ID EP348494
- DOI 10.9734/BJMMR/2015/19502
- Views 57
- Downloads 0
Clinical and Imaging Findings of Symptomatic Right Aortic Arch and Double Aortic Arch: Case Report
Aim: Anomalies of aortic arch are uncommon, accounting for only 1-3% of all congenital cardiac diseases. A vascular ring results from the abnormal development of an aortic arch complex. Generally, it manifests with trach...
Work-related Musculoskeletal Disorders among Workers at Gold Mine Industry in Ghana: Prevalence and Patterns of Occurrence
Background: Work-related Musculoskeletal Disorders (WRMSDs) constitutes major constraint to optimal performance among workers. However, information about its prevalence and pattern of occurrence among Ghanaians working i...
Non-invasive Assessment of the Severity of Aortic Stenosis by Doppler Derived Aortic Valve Coefficient: A Retrospective Feasibility Study in Humans
Background: Accurate assessment of the severity of stenosis is critical in patients with aortic stenosis. The ambiguities and imprecisions of the current diagnostic parameters can result in sub-optimal clinical decisions...
A Modified Technique for Repair of Triceps Avulsion Using Suture Anchors-A Case Report
The bony avulsion of the Triceps is a rare injury. The Triceps tendon injury accounts for <1% of all tendon injuries. Various surgical techniques have been described for the repair. We describe our variation of suture an...
Determinants of Maternal Mortality in North Eastern Nigeria: A Population Based Study
Aims: The aim of this study is to explore the determinants of maternal mortality across urban and rural areas of Borno State, North Eastern Nigeria. Method: A cross-sectional study design was used. Data were sourced fro...