Early but no long-term benefit of regional compared with general anesthesia for ambulatory hand surgery.

dc.contributor.authorMcCartney, Colin JL
dc.contributor.authorBrull, Richard
dc.contributor.authorChan, Vincent
dc.contributor.authorKatz, Joel
dc.contributor.authorAbbas, Sherif
dc.contributor.authorGraham, Brent
dc.contributor.authorNova, Hugo
dc.contributor.authorRawson, Regan
dc.contributor.authorAnastakis, Dimitri
dc.contributor.authorvon Schroeder, Herb
dc.date.accessioned2013-10-25T16:15:09Z
dc.date.available2013-10-25T16:15:09Z
dc.date.issued2004-08
dc.description.abstractBackground: The purpose of this study was to determine whether either regional anesthesia (RA) or general anesthesia (GA) provided the best analgesia with the fewest adverse effects up to 2 weeks after ambulatory hand surgery. Methods: Patients undergoing ambulatory hand surgery were randomly assigned to RA (axillary brachial plexus block; n = 50) or GA (n = 50). Before surgery, all patients rated their hand pain (visual analog scale) and pain-related disability (Pain-Disability Index). After surgery, eligibility for bypassing the postanesthesia care unit ("fast track") was determined, and pain, adverse effects, and home-readiness scores were measured. On postoperative days 1, 7, and 14, patients documented their pain, opioid consumption, adverse effects, Pain-Disability Index, and satisfaction. Results: More RA patients were fast-track eligible (P < 0.001), whereas duration of stay in the postanesthesia care unit was shorter in the RA group (P < 0.001). Time to first analgesic request was longer in the RA group (P < 0.001), and opioid consumption was reduced before discharge (P < 0.001). In the RA group, the pain ratings measured at 30, 60, 90, and 120 min after surgery were lower (P < 0.001), and patients spent less time in the hospital after surgery (P < 0.001). More GA patients experienced nausea/ vomiting during recovery in the hospital (P < 0.05). However, on postoperative days 1, 7, and 14, there were no differences in pain, opioid consumption, adverse effects, Pain-Disability Index, or satisfaction. Conclusions: Despite significant reduction in pain before discharge from the hospital after ambulatory hand surgery, singleshot axillary brachial plexus block does not reduce pain at home on postoperative day 1 or up to 14 days after surgery when compared with GA. However, RA does provide other significant early benefits, including reduction in nausea and faster discharge from the hospital.en_US
dc.identifier.citationAnesthesiology. 2004 Aug;101(2):461-7.
dc.identifier.issnISSN: 0003-3022, ESSN: 1528-1175
dc.identifier.urihttp://hdl.handle.net/10315/26532
dc.language.isoen_USen_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.rights.articlehttp://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2004&issue=08000&article=00028&type=abstract
dc.rights.journalhttp://journals.lww.com/co-anesthesiology/pages/default.aspxen_US
dc.rights.publisherhttp://www.lww.comen_US
dc.titleEarly but no long-term benefit of regional compared with general anesthesia for ambulatory hand surgery.
dc.typeArticleen_US

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