Hoarseness of Voice following Left Supraclavicular Brachial Plexus Block: A Case Report.

Supraclavicular brachial plexus block is extensively used for primary regional anaesthesia as well as postoperative analgesia for the surgical procedures of the upper limb. The evidence for the use of ultrasound in supraclavicular brachial plexus is growing day by day as it has the advantage of allowing real time visualisation of the plexus, pleura and vessels along with the needle and local anaesthetics spread. Despite this, complications can even arise with ultrasound guided supraclavicular brachial plexus block. Hoarseness of voice due to recurrent laryngeal nerve block is a rare complication of supraclavicular brachial plexus block. There are few reported cases of hoarseness of voice following the right supraclavicular block. There is only one reported case of hoarseness of voice following the left supraclavicular block. Here, we report a case of a 16-year-old boy who developed hoarseness of voice due to left recurrent laryngeal nerve following ultrasound guided left supraclavicular brachial plexus block.

Current practice of pre-anaesthesia preparation and perioperative parental satisfaction during paediatric ambulatory procedures in a developing country - An observational study.

OBJECTIVE: To assess the extent of preoperative information provided to patients' parents, their expressed need for more information and its effect on paediatric anxiety and parental satisfaction with the perioperative care provided. DESIGN: Prospective observational study. SETTING: Public university hospital. PARTICIPANTS: 100 children, 2-12 years scheduled to undergo elective day-care surgery under general anaesthesia. OUTCOMES MEASURED: The parents were interviewed preoperatively with a questionnaire, which included a list of items about preoperative preparation likely to contribute to patients' satisfaction with the health care services. The baseline anxiety level in the participant children and its possible predictors were recorded. Before discharge, the parents were asked a questionnaire for satisfaction scoring. RESULTS: Eighty-five (85%) parents were aware of the surgical procedure whereas 5 (5%) were aware of anaesthesia. Seventy-five (79%) families were not keen to know about anaesthesia. Amongst all the parents surveyed, 16 (16%) reported that receiving more information on anaesthesia would increase their anxiety while 84 (84%) reckoned that although more information would not increase their anxiety, it was unnecessary. Preoperative baseline anxiety was identified in 71 (71%) of children with a median mYPAS of 46.4 (95%CI: 41.4, 48.64). Amongst the potential predictors of anxiety analysed, low paternal education level was associated with high preoperative anxiety in children (adjusted OR: 3.67; 95%CI: 1.35, 9.99; P=0.01). Ninety-four (94%) and 57 (57%) parents expressed satisfaction with the obtained information from the surgeon and anaesthesiologist, respectively. CONCLUSION: The present study revealed the high incidence of preoperative anxiety in children and highlighted the expectations of parents regarding preoperative preparation suggesting the need to evolve the existing preparatory program in the context of a developing world setting.