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Factores asociados con anestesia regional fallida de plexo braquial para cirugía de extremidad superior.

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Title: Factores asociados con anestesia regional fallida de plexo braquial para cirugía de extremidad superior.
Alternate Title: Factors associated with brachial plexus regional anesthesia failure for upper limb surgery.
Authors: Moreno-Martínez, Diego Alberto1,2 diegomoreno@javeriana.edu.co, Perea-Bello, Ana Helena1,2, Díaz-Bohada, Judy Lorena1, García-Rodriguez, Diana Margarita1, Echeverri-Mallarino, Verónica1, Valencia-Peña, Maury Julieth3, Osorio-Cardona, Walter1, Silva-Enríquez, Paola Nathaly4
Source: Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología. 2016, Vol. 44 Issue 4, p292-298. 7p.
Abstract (English): Introduction: Brachial plexus block as an anesthetic technique for upper limb surgery has some advantages over general anesthesia. The technique is widely used in our practice, with high effectiveness and adequate safety profile. However, the relationship between block failure and failure-determining factors has not been measured. Objectives: To identify and quantify brachial plexus block failure-associated factors for upper limb surgery as an initial observation aimed at developing prevention-oriented risk profiles and strategies. Materials and methods: An analytical observational study was conducted by collecting data from electronic medical records of upper limb surgery using brachial plexus block from the San Ignacio University Hospital between 2011 to 2012. Block failures were identified using standardized clinical criteria, measuring potentially associated factors. Dichotomous comparisons were made and uni- and multivariate logistic regression analysis was performed to identify potential statistically significant variables, based on failed cases and successful controls. Results: None of the proposed factors was independently associated with failure of brachial plexus block. A qualitative description of failed cases presented confounding factors associated with local practices and the failure characteristics did not show a clinically plausible trend. Conclusions: There were no factors determined by patient, anesthetic procedure, surgical procedure and operator that could be independently associated with brachial plexus block failure. The suggestion is to fine-tune the definition of failures, not just in the research environment, but in the current clinical practice; to improve the anesthesia records to rise the numbers and the quality of data bases for a quantitative determination of the risk of peripheral regional anesthesia failure and design prevention strategies focused on risk groups. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: El bloqueo de plexo braquial como técnica anestésica para cirugía de extremidad superior presenta ventajas sobre la anestesia general. Es ampliamente usada en nuestro medio con alta efectividad y adecuado perfil de seguridad. Sin embargo, no existe la cuantificación de las asociaciones entre fallo del bloqueo y factores determinantes del fallo. Objetivos: Identificar y cuantificar los factores asociados al fallo del bloqueo de plexo braquial como observación inicial para crear perfiles de riesgo y estrategias para prevenirlo. Materiales y métodos: Se realizó un estudio observacional analítico, recolectando los datos de historias clínicas de bloqueos de plexo braquial para cirugía de miembro superior del Hospital Universitario San Ignacio de los años 2011-2012, identificando los bloqueos fallidos con criterios clínicos estandarizados, midiendo los factores potencialmente asociados a estos. Partiendo del grupo de fallos (casos) y grupo exitoso (controles) se establecieron comparaciones dicotómicas y análisis de regresión logística con análisis uni y multivariado para identificar variables con significancia estadística. Resultados: Ninguno de los factores propuestos se asoció de forma independiente al fallo de bloqueo de plexo braquial. La descripción cualitativa de los casos fallidos presenta factores de confusión asociados a prácticas clínicas locales y ninguna tendencia clínicamente plausible en la característica de los fallos. Conclusiones: Ningún factor determinado por el paciente, procedimiento anestésico, procedimiento quirúrgico, operador se asocia de forma independiente a fallo del bloqueo de plexo braquial. Se propone afinar la definición de fallo, no solo en el contexto investigativo, sino en la práctica clínica actual, mejorar los sistemas de registro en anestesia para ampliar en número y calidad las bases de datos que permitan aproximarse cuantitativamente al riesgo de fallo de anestesia regional periférica y plantear estrategias de prevención enfocadas en grupos de riesgo. [ABSTRACT FROM AUTHOR]
Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Factores asociados con anestesia regional fallida de plexo braquial para cirugía de extremidad superior.
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  Data: Factors associated with brachial plexus regional anesthesia failure for upper limb surgery.
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  Data: <searchLink fieldCode="AR" term="%22Moreno-Martínez%2C+Diego+Alberto%22">Moreno-Martínez, Diego Alberto</searchLink><relatesTo>1,2</relatesTo><i> diegomoreno@javeriana.edu.co</i><br /><searchLink fieldCode="AR" term="%22Perea-Bello%2C+Ana+Helena%22">Perea-Bello, Ana Helena</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Díaz-Bohada%2C+Judy+Lorena%22">Díaz-Bohada, Judy Lorena</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22García-Rodriguez%2C+Diana+Margarita%22">García-Rodriguez, Diana Margarita</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Echeverri-Mallarino%2C+Verónica%22">Echeverri-Mallarino, Verónica</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Valencia-Peña%2C+Maury+Julieth%22">Valencia-Peña, Maury Julieth</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Osorio-Cardona%2C+Walter%22">Osorio-Cardona, Walter</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Silva-Enríquez%2C+Paola+Nathaly%22">Silva-Enríquez, Paola Nathaly</searchLink><relatesTo>4</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Colombian+Journal+of+Anesthesiology+%2F+Revista+Colombiana+de+Anestesiología%22">Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología</searchLink>. 2016, Vol. 44 Issue 4, p292-298. 7p.
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Introduction: Brachial plexus block as an anesthetic technique for upper limb surgery has some advantages over general anesthesia. The technique is widely used in our practice, with high effectiveness and adequate safety profile. However, the relationship between block failure and failure-determining factors has not been measured. Objectives: To identify and quantify brachial plexus block failure-associated factors for upper limb surgery as an initial observation aimed at developing prevention-oriented risk profiles and strategies. Materials and methods: An analytical observational study was conducted by collecting data from electronic medical records of upper limb surgery using brachial plexus block from the San Ignacio University Hospital between 2011 to 2012. Block failures were identified using standardized clinical criteria, measuring potentially associated factors. Dichotomous comparisons were made and uni- and multivariate logistic regression analysis was performed to identify potential statistically significant variables, based on failed cases and successful controls. Results: None of the proposed factors was independently associated with failure of brachial plexus block. A qualitative description of failed cases presented confounding factors associated with local practices and the failure characteristics did not show a clinically plausible trend. Conclusions: There were no factors determined by patient, anesthetic procedure, surgical procedure and operator that could be independently associated with brachial plexus block failure. The suggestion is to fine-tune the definition of failures, not just in the research environment, but in the current clinical practice; to improve the anesthesia records to rise the numbers and the quality of data bases for a quantitative determination of the risk of peripheral regional anesthesia failure and design prevention strategies focused on risk groups. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción: El bloqueo de plexo braquial como técnica anestésica para cirugía de extremidad superior presenta ventajas sobre la anestesia general. Es ampliamente usada en nuestro medio con alta efectividad y adecuado perfil de seguridad. Sin embargo, no existe la cuantificación de las asociaciones entre fallo del bloqueo y factores determinantes del fallo. Objetivos: Identificar y cuantificar los factores asociados al fallo del bloqueo de plexo braquial como observación inicial para crear perfiles de riesgo y estrategias para prevenirlo. Materiales y métodos: Se realizó un estudio observacional analítico, recolectando los datos de historias clínicas de bloqueos de plexo braquial para cirugía de miembro superior del Hospital Universitario San Ignacio de los años 2011-2012, identificando los bloqueos fallidos con criterios clínicos estandarizados, midiendo los factores potencialmente asociados a estos. Partiendo del grupo de fallos (casos) y grupo exitoso (controles) se establecieron comparaciones dicotómicas y análisis de regresión logística con análisis uni y multivariado para identificar variables con significancia estadística. Resultados: Ninguno de los factores propuestos se asoció de forma independiente al fallo de bloqueo de plexo braquial. La descripción cualitativa de los casos fallidos presenta factores de confusión asociados a prácticas clínicas locales y ninguna tendencia clínicamente plausible en la característica de los fallos. Conclusiones: Ningún factor determinado por el paciente, procedimiento anestésico, procedimiento quirúrgico, operador se asocia de forma independiente a fallo del bloqueo de plexo braquial. Se propone afinar la definición de fallo, no solo en el contexto investigativo, sino en la práctica clínica actual, mejorar los sistemas de registro en anestesia para ampliar en número y calidad las bases de datos que permitan aproximarse cuantitativamente al riesgo de fallo de anestesia regional periférica y plantear estrategias de prevención enfocadas en grupos de riesgo. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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