Snyman Jenna, Goldstein Lara Nicole
Division of Emergency Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Afr J Emerg Med. 2019 Dec;9(4):177-179. doi: 10.1016/j.afjem.2019.05.006. Epub 2019 Jun 26.
Nerve blocks are commonplace in the operating theatre and have recently made their way into emergency centres as a viable alternative to traditional methods of analgesia. Their use and safety has been documented for a variety of pathologies and it has been shown that they spare opioids and shorten time to discharge. No data exists on their use in South Africa. The purpose of this study was to analyse data from an existing nerve block registry from an emergency centre in South Africa.
The study was a retrospective, descriptive analysis of a nerve block registry from an academic emergency centre in Johannesburg, South Africa from May 2016 to September 2017.
There were 168 nerve blocks performed by 36 different operators of varying experience. The most common indication was for fracture management and the most frequently performed blocks were femoral 3-in-1 (44.6%), pop-sciatic (16.7%) and forearm-ultrasound nerve blocks (16.7%). Ultrasound guidance was used in 88.6% of the blocks. The average time taken to perform a nerve block was 10 min. The success rate was 91.8%. None of the variables analysed (i.e., operator experience, type of nerve block performed, time taken to perform the nerve block, ultrasound guidance, amount of anaesthetic used and time taken to evaluate outcome) had any effect on the success rate.
This study illustrates the use of nerve blocks as an effective, safe and timeous analgesic solution to a wide variety of musculoskeletal injuries in an academic emergency centre in South Africa.
神经阻滞在手术室很常见，最近已进入急诊中心，成为传统镇痛方法的可行替代方案。其在各种病症中的使用和安全性已有文献记载，并且已表明它们可节省阿片类药物并缩短出院时间。南非尚无关于其使用的数据。本研究的目的是分析来自南非一家急诊中心现有神经阻滞登记处的数据。
本研究是对南非约翰内斯堡一家学术急诊中心2016年5月至2017年9月的神经阻滞登记处进行的回顾性描述性分析。
由36名经验各异的不同操作者进行了168次神经阻滞。最常见的适应症是骨折处理，最常进行的阻滞是股三合一阻滞（44.6%）、坐骨神经-股后皮神经阻滞（16.7%）和前臂超声引导神经阻滞（16.7%）。88.6%的阻滞使用了超声引导。进行一次神经阻滞的平均时间为10分钟。成功率为91.8%。分析的所有变量（即操作者经验、所进行的神经阻滞类型、进行神经阻滞的时间、超声引导、所用麻醉剂的量以及评估结果的时间）对成功率均无影响。
本研究表明，在南非一家学术急诊中心，神经阻滞可作为一种有效、安全且及时的镇痛方法，用于治疗多种肌肉骨骼损伤。
