Article Text
Abstract
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Background and Aims The use of ultrasound for precise delivery of local anaesthetics has been a breakthrough in the field of regional anaesthesia. However, it has still not found its place in many small towns of the developing nations. Lack of trained anaesthesiologists, inaccessibility to the required armamentarium and resistance from surgeons are prime factors responsible for the same. Our aim was to establish ultrasound guided regional anaesthesia (UGRA) as a standard of care in an orthopaedic centre in rural India where it was never used as an anaesthetic technique.
Methods This is a retrospective analysis of 312 patients with upper limb trauma operated under ultrasound guided regional anaesthesia (UGRA) between January 2022 to April 2023. We assessed the effectiveness of the block using pain scores at rest and on movement, the need for rescue anaesthesia and perioperative outcome in these patients.
Results A total of 312 patients received UGRA in this study. 58% of the patients were ASA grade 1 and 2. 42% patients came under ASA grade 3 and 4. 30% patients from ASA 1 and 2 categories required additional conscious sedation in the intraoperative period. However, none of the patients from the ASA 3 and 4 required any sedation and were done solely under USGRA.
Conclusions 1. USGRA proves to be a safe and reliable choice of anaesthesia in high risk cases if appropriate equipments and expertise are available. 2. Confidence, Competence and Conviction can help this state of art technique to penetrate in areas where it has still not found its way.