During the year 2009 (05.01.-23.12.2009.) in the special hospital for orthopaedic surgery „Akromion“ there were a total of 1075 anaesthetics performed involving 1754 anaesthesia procedures (nerve blocks, general anaesthetics).
Four hundred and eight patients had their procedure done in our „day surgery“ programme (hospital discharge within 2-7 hours after surgery) while 667 remained in hospital for at least one night.
699 surgeries were performed under regional anaesthesia (with or without sedation), mostly lower extremity nerve blocks and neoraxial anaesthesia.
342 patients received a combination of general anaesthesia and peripheral nerve block of which the majority were brachial plexus blocks combined with general anaesthesia for shoulder and upper extremity surgery.
22 patients received general anaesthesia alone, while 12 minor surgical procedures were performed in patients receiving only analgosedation.
Of the 364 patients receiving general anaesthesia, airway patency was maintained using a laryngeal mask airway (LMA) in 322 while in 42 patients an endotracheal tube was inserted.
In 1075 patients a total of 1382 regional anaesthetic procedures were performed, of which 679 neuraxial (mostly spinal) and 703 peripheral nerve blocks.
According to nerve block area
There was a total of 678 neuraxial anaesthesia procedures performed in which anaesthetics are delivered into the subarachnoid or epidural space. In 392 cases the subarahnoid block („spinal“ anaesthesia) was performed using a hyperbaric local anaesthetic mixture with the aim of achieving unilateral anaesthesia affecting predominantly the leg to be operated while sparing the other extremity. 280 patients received a „classic“ subarachnoid block involving both legs.
Along with the local anaesthetic in 622 patients an opioid analgesic was administered intrathecaly: 426 times sufentanil alone, 143 times a combination of sufentanil and morphine, and 53 times morphine alone was added for postoperative analgesia.
In 5 patients an intrathecal catheter (Spinocath®) was used for anaesthesia and postoperative analgesia, while in one patient a combined spinal-epidural technique was used.
In 337 patients one of the peripheral nerve blocks involving the brachial plexus was performed.
For postoperative analgesia 27 patients had a catheter inserted using the posterior cervical paravertebral approach.
A femoral nerve block was used in 171 patients of which 131 had a catheter inserted for postoperative analgesia and physical therapy facilitation. The saphenus nerve was selectively blocked using a transsartorial approach in 2 patients.
An sciatic nerve block was performed 177 times – 154 times using a transgluteal („Labat“) approach; 23 times a suprapopliteal approach with a catheter inserted in 10 patients was used, and one patient had a catheter inserted using a parasacral approach. A tarsal (ankle) block was performed in three patients.
A psoas compartment block of the lumbar plexus was performed 8 times with 5 catheters for postoperative analgesia inserted.