European Journal of Anaesthesiology:
Abstracts and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: ESA Best Abstract Prize Competition (BAPC)
Barrington, M. J.; Thomas, R. D.; Tay, V. S.
St Vincent's Hospital, Melbourne, Department of Anaesthesiology, Melbourne, Australia
Background and Goal of Study: The Australian and New Zealand Registry of Regional Anaesthesia (AURORA) measures the effectiveness and safety of peripheral nerve blockade (PNB). Since the introduction of ultrasound (US)‐guided PNB, clinical practice has evolved significantly, however case reports of serious complications raise safety concerns. In this report we inform the quality and safety of PNB performed on 10, 000 patients registered with AURORA.
Materials and Methods: The period of study was June 2008 to December 2010, with the study population comprising all patients receiving PNB from 14 hospitals in Australia, New Zealand and Malaysia. Data was recorded measuring the effectiveness of PNB and complications. All patients were systematically followed up for complications with outcome as previously defined.1 We determined that a cohort of 10, 000 patients would accurately establish the incidence of complications. Data are presented as percentage (%) or mean ± SD and adverse events expressed as n/1000.
Results and Discussion: The patient population (n = 10, 112), age 58 ± 19 years, weight 80 ± 21 kg, females (49%), males (51%) received 12, 792 PNBs. Table 1 lists immediate and delayed complications.
AURORA has captured trends in the clinical practice and major complications of PNB including cardiac arrest, tension pneumothorax, wrong‐site anesthesia and nerve injury.
Conclusion(s): Serious complications associated with PNB occur infrequently. However, these complications represent a significant variation in the quality of care and indicate that ongoing systematic monitoring of PNB is important.
1. Barrington et. al.: Preliminary results of the Australasian Regional Anaesthesia Collaboration: a prospective audit of more than 7000 peripheral nerve and plexus blocks for neurologic and other complications. Reg Anesth Pain Med 2009; 34: 534-41.
Acknowledgements: Anaesthetists who contributed data to AURORA. This project has received funding from the Australian and New Zealand College of Anaesthetists.