Our Ultrasound Guided Brachial Plexus Block Experiences for Upper Extremity Surgeries in Pediatric Patients

Özet

Objectives: Brachial plexus block is the most effective analgesia and anesthesia procedure for the upper extremity surgeries in pediatricpatients. In recent years, ultrasound guidance for this procedure has reduced the fail and complications like pneumothorax,intravascular injection and nerve damage. However, the number of studies about brachial plexus block is not enough, particularlyin pediatric patients, which remained under-researched. In our study, we aimed to discuss the efficacy and safety of the ultrasoundguidedbrachial plexus block in pediatric patients by retrospectively examining their data.Methods: We retrospectively reviewed the data of pediatric patients who underwent ultrasound-guided brachial block in ourclinic between January 2015-January 2017. Demographic data, diagnosis, procedure and operation times, medications, motor andsensorial block times were recorded.Results: Between January 2015 and January 2017, the number of pediatric patients who underwent ultrasound-guided peripheralnerve block in our clinic was 24. In 15 of these patients, the supraclavicular block was applied in 15, and the infraclavicular blockwas applied in nine patients. The mean age of the patients was 9.6±3.12, with a male/female ratio 14/10. The mean duration ofthe procedure was 9.54±2.14 minutes in patients for the supraclavicular block and 12.9 ± 2.8 minutes for the infraclavicular block.The mean surgery time was 64±13.6 minutes. As a local anesthetic, bupivacaine was used in three patients; bupivacaine+lidocainecombination was used in 21 patients and adjuvants were added in eight patients. The block procedure was performed undergeneral anesthesia in 12 patients and under sedation in 12 patients. The mean motor block time was 7.5±2 hours in patients whoreceived supraclavicular block, and 7.4±1.5 hours in patients who received infraclavicular block. The mean sensorial block time was10.5±1.7 hours in the supraclavicular block, and 10.45±1.15 hours in the infraclavicular block. The mean motor block period withadded adjuvants was 7.7±0.5 hours, and the sensorial block period was 11.12±1.1 hours. No complications were seen during theprocedure, intraoperative and postoperative follow-up.Conclusion: Ultrasound-guided brachial plexus block in pediatric patients is effective and safe, with longer analgesia duration andlower complication rates. Prospective studies with a larger number of patients are needed in this regard.