Nervous breakdown! A registry of nerve blocks from a South African emergency centre

INTRODUCTION: Nerve blocks are commonplace in the operating theatre and have recently made their way into emergency centres as a viable alternative to traditional methods of analgesia. Their use and safety has been documented for a variety of pathologies and it has been shown that they spare opioids and shorten time to discharge. No data exists on their use in South Africa. The purpose of this study was to analyse data from an existing nerve block registry from an emergency centre in South Africa. METHODS: The study was a retrospective, descriptive analysis of a nerve block registry from an academic emergency centre in Johannesburg, South Africa from May 2016 to September 2017. RESULTS: There were 168 nerve blocks performed by 36 different operators of varying experience. The most common indication was for fracture management and the most frequently performed blocks were femoral 3-in-1 (44.6%), pop-sciatic (16.7%) and forearm-ultrasound nerve blocks (16.7%). Ultrasound guidance was used in 88.6% of the blocks. The average time taken to perform a nerve block was 10 min. The success rate was 91.8%. None of the variables analysed (i.e., operator experience, type of nerve block performed, time taken to perform the nerve block, ultrasound guidance, amount of anaesthetic used and time taken to evaluate outcome) had any effect on the success rate. CONCLUSION: This study illustrates the use of nerve blocks as an effective, safe and timeous analgesic solution to a wide variety of musculoskeletal injuries in an academic emergency centre in South Africa.