Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Moshammer, M; Klim, SM; Glehr, R; Hauer, G; Hecker, A; Leithner, A; Glehr, M.
Local anaesthesia vs. brachial plexus block in trapeziometacarpal joint arthroplasty.
Arch Orthop Trauma Surg. 2024; 145(1): 83
Doi: 10.1007/s00402-024-05637-3
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- Führende Autor*innen der Med Uni Graz
- Glehr Mathias
- Moshammer Maximilian
- Co-Autor*innen der Med Uni Graz
- Glehr Reingard Christina
- Hauer Georg
- Hecker Andrzej Stanislaw
- Klim Sebastian Martin
- Leithner Andreas
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- Abstract:
- INTRODUCTION: An established anaesthetic procedure used during total trapeziometacarpal joint (TMCJ) arthroplasty is the brachial plexus block (BPB). It was hypothesized that local anaesthesia (LA) provides advantages in overall cost, enables intraoperative assessment of the prosthesis, and minimises the anaesthetic risk. In this study, LA to BPB was compared and outcomes, safety, and overall patient satisfaction were analyzed. MATERIALS AND METHODS: In this single-center cohort study, 32 patients (34 operated thumbs) who underwent total TMCJ arthroplasty between February 2018 and July 2021 were included. Two groups were formed depending on the anaesthetic method used. One group was operated under LA, and the other under BPB. Functionality scores were assessed preoperatively and three month postoperatively. Additionally, pain was assessed on the 1st and 12th postoperative day. Data on intraoperative pain and anxiety, overall satisfaction, pain medication use, and willingness to undergo the procedure again were gathered through a retrospective telephone survey. RESULTS: No significant differences between LA and BPB were found in terms of functional outcomes, pain reduction, and willingness to repeat the procedure. The analysis further showed significant differences in intraoperative anxiety (higher in the LA group; LA 1.69, SD: 2.65; BPB 0.28, SD: 0.58; measured using a numeric rating scale 0-10; p = 0.045), operation length (higher in BPB group; LA 39 min, SD: 7.46; BPB 45 min, SD: 7.02; p = 0.018) and overall setup time (higher in BPB group; LA 76 min, SD: 15.85; BPB 102 min, SD: 19.66; p < 0.001). No conversion from LA to another anaesthetic method was necessary. CONCLUSION: The use of LA in total TMCJ arthroplasty is a practical and reliable alternative to the well-established BPB. LA reduces the cost of the procedure, necessity of an anaesthesiology team and the duration of the patients´ hospital stay. Patients should be actively involved in selecting the anaesthetic method to optimize the operative procedure and overall outcome.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Male - administration & dosage
- Female - administration & dosage
- Aged - administration & dosage
- Brachial Plexus Block - methods
- Middle Aged - administration & dosage
- Anesthesia, Local - methods
- Retrospective Studies - administration & dosage
- Carpometacarpal Joints - surgery
- Trapezium Bone - surgery
- Patient Satisfaction - administration & dosage
- Find related publications in this database (Keywords)
- Trapeziometacarpal arthroplasty
- Local anaesthesia
- Pain
- Moovis prosthesis
- Reliability
- Anxiety