A comparison of general anesthesia versus axillary brachial plexus block for hand and wrist surgery in the view of patient satisfaction

Abstract

Background: We evaluated whether the analgesic superiority ofregional block over general anesthesia improves patient satisfaction. Methods: Patients were anesthetized with either general anesthesia(GA) (n = 30) or axillary brachial plexus block (BPB) (n = 30). GA was standardized to include induction with propofol and alfentaniland maintenance with desflurane in an oxygen/nitrous oxidemixture. BPB was performed using an axillary perivascular approach,and 1.5% lidocaine 20 ml with epinephrine (1 : 200,000) and0.5% levobupivacaine 20 ml were injected. Pain scores and numbersof times pushing the patient-controlled analgesia (PCA) buttonwere measured preoperatively and at 2, 6, and 24 hours after theend of surgery. On the first day after the operation, one of ourresearchers visited the patients to document their opinions of theiranesthetic experiences and their satisfaction scores. Results: Group BPB had lower visual analog scale scores at 2hours and 6 hours postoperatively. Numbers of times pushing thePCA button was also lower in Group BPB within the first 2 hoursand between 2–6 hours postoperatively. However, patient satisfactionscores were not statistically different between the two groups(84 ± 11 vs. 88 ± 12, P = 0.177). Conclusions: BPB provided superior analgesia after upper limbsurgery compared to GA, but for a complete understanding ofpatients’ satisfaction, detailed consideration of factors such assedation would be necessary.