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ABSTRACT
Introduction. Echo guidance improves patient safety in locoregional anesthesia (LRA). Objective. To evaluate the practice of ultrasound-guided blocks in adults in Malian adults. Patients and Methods. Our prospective cross-sectional observational study was conducted in the anesthesia-intensive care unit, orthopedic traumatology, and thoracic and cardiovascular surgery departments of Hopital du Mali (Bamako) from August 2022 to January 2023 (six months). Results During the study period, 30 patients met our criteria (2.2%). The sex ratio was 5. The mean age was 40.8 ± 18.5 years. Most patients came from the orthopedic traumatology department (90%) and had scheduled surgeries (60%). The ASA score was mostly ASA I (66.7%). Pharmacological premedication was done in 23.3% of patients. Axillary block was performed in 53.3% of cases. Bupivacaine was the most commonly used drug, with dexamethasone as an adjuvant in 30% of cases. The mean anesthetic volume was 21.2 ± 2.8 mL, with a delivery time of 9.5 ± 3.55 minutes and an installation time of 11.5 ± 6.3 minutes. The combination of bupivacaine and lidocaine led to a faster installation. An accident occurred in 3.3% of cases. Surgery lasted 58.4 ± 31.5 minutes and the sensory block duration was 271.07 ± 107.98 minutes. Postoperatively, morphine sparing was possible in 93.4% of patients with reduced hospital stay and high satisfaction in 86.7% of cases. Conclusion. Ultrasound-guided LRA should bepromoted, particularly in ambulatory limb surgery.


RÉSUMÉ
Introduction. Le guidage échographique améliore la sécurité des patients lors de l'anesthésie locorégionale (ALR). Objectif. Évaluer la pratique des blocs échoguidés chez l'adulte au Mali. Patients et méthodes. Notre étude observationnelle transversale prospective a été menée dans les services d'anesthésie-réanimation, de traumatologie orthopédique et de chirurgie thoracique et cardiovasculaire de l'hôpital du Mali (Bamako) d'août 2022 à janvier 2023 (six mois). Résultats Durant la période d'étude, 30 patients répondaient à nos critères (2,2 %). Le sex-ratio était de 5. L'âge moyen était de 40,8 ± 18,5 ans. La plupart des patients provenaient du service de traumatologie orthopédique (90%) et avaient des chirurgies programmées (60%). Le score ASA était principalement ASA I (66,7 %). Une prémédication pharmacologique a été réalisée chez 23,3 % des patients. Un bloc axillaire a été réalisé dans 53,3 % des cas. La bupivacaïne était le médicament le plus couramment utilisé, avec la dexaméthasone comme adjuvant dans 30 % des cas. Le volume anesthésique moyen était de 21,2 ± 2,8 ml, avec un temps d'administration de 9,5 ± 3,55 minutes et un temps d'installation de 11,5 ± 6,3 minutes. La combinaison de bupivacaïne et de lidocaïne a permis une pose plus rapide. Un accident est survenu dans 3,3 % des cas. L'intervention chirurgicale a duré 58,4 ± 31,5 minutes et la durée du bloc sensoriel a été de 271,07 ± 107,98 minutes. En postopératoire, l'épargne morphinique a été possible chez 93,4 % des patients avec une durée d'hospitalisation réduite et une grande satisfaction dans 86,7 % des cas. Conclusion. L'ARS guidée par ultrasons devrait être promue, en particulier dans la chirurgie ambulatoire des membres.

Keywords

Truncular Blocks Limbs Echoguided Mali Blocs tronculaires Membres Echoguidés Mali

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Amadou Sidibé, Seydina Alioune Beye, Tall Fadima Koureïssi, Siaka Badimi, Amadou Gamby, Kalil Sangho, Maxime Coulibaly, Ahmadou I Dramé, Kalba Tembiné, Bourama Kéita, Joseph Koné, Modibo Sangaré, & Nouhoum Diani. (2024). Ultrasound-Guided Loco-Regional Anesthesia of Limb Surgery in Mali: Anesthésie Loco-Régionale Échoguidée dans la Chirurgie des Membres au Mali. HEALTH SCIENCES AND DISEASE, 25(9). Retrieved from https://hsd-fmsb.org/index.php/hsd/article/view/6030
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