Abstract
The shortage of medical staff in rural areas of Japan is an ongoing problem. As anesthesiologists are becoming centered on urban areas, rural-based orthopedists are becoming less able to secure safe anesthesia for patients with cardiac disease or those taking anticoagulant drugs.
This study was conducted to determine whether safe anesthesia of the upper and lower limbs can be obtained using ultrasound-guided peripheral nerve block by an orthopedist working alone. The proportion of patients showing a fall in blood pressure in the nerve block group was 16%, being significantly lower than the 31% of patients receiving spinal anesthesia for bone and joint surgery of the lower limbs. In addition, in the nerve block group, no patients required vasopressor agents. Symptoms of local anesthesia toxicity developed in one patient who underwent hip joint operations.
In four patients with humerus proximal part fracture, stable anesthesia was obtained and the proportion showing blood pressure reduction was 23%.
