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Nov 30, 2018 News
Over the years, the Georgetown Public Hospital Corporation (GPHC) have been limited to offering only spinal and general anaesthesia to patients in need of lower limb surgeries. However, Dr. Haiyun Du recently brought to Guyana, the experience and expertise to carry out an operation known as Lumbar Plexus Sciatic Nerve Block.
Dr. Du is an anaesthesiologist, consultant at the anaesthesia department of GPHC and a member of the China Medical Team. He came to Guyana from the Yancheng No. 1 People’s Hospital four months ago.
Lumbar Plexus Sciatic Nerve Block is an operation in which a puncture is made directly at the site of surgery, the nerve is located and a local anaesthetic is injected.
In this process the nerve affected is targeted and numbed instead of general anaesthesia which involves “putting the patient to sleep” or in a state of unconsciousness and body numbness.
It is also different from spinal anaesthesia, whereby the patient is numbed from the spinal cord downward.
The first ever lumbar plexus sciatic nerve block performed by Dr. Haiyun Du was on October 12, last, on a 58-year-old male suffering a tibiofibular fracture ( a fracture of the joint between his tibia and fibula, which are lower leg bones, immediately below the outside of your knee).
The process was demonstrated and explained to the members of the anaesthesia department by Dr. Du as he performed the operation.
To date Dr. Du have performed over 20 surgeries. He aims to have a functional regional anaesthesia arm of the department and to train other doctors to perform the procedures of lumbar plexus sciatic nerve block.
With the introduction of lumbar plexus sciatic nerve block, it was highlighted by Dr. Du that patients are subjected to less (pain-related) drug consumptions, along with less side effects such as vomiting, constipation and urinary retention, which are common with the drugs used in general and spinal anaesthesia
When compared to spinal anaesthesia it was reported that spinal anaesthesia has a greater impact on the hemodynamic of patients (the force that stimulates change or progress of blood flow), especially elderly patients, and possibly causing severe hypotension and posing a risk to life.
Meanwhile, in comparison to general anaesthesia it was highlighted that general anaesthesia poses a higher risk of pulmonary post operatives’ adverse events than the regional technique, especially in patients with pulmonary dysfunction and the elderly.
Aside from the introduction of the lumbar plexus sciatic nerve block to GPHC, the anaesthesiologist also introduced a new anaesthetic to the hospital. The drug Ropivacaine was introduced by Dr. Du as a substitute for Bupivacaine. Ropivacaine is reportedly less toxic to the heart.
In an interview with Kaieteur News, Dr. Du and Dr. Onica Higgins, a registrar in the department of anaesthesia and intensive care it was explained that “lumbar plexus sciatic nerve block is basically a form of regional anaesthesia where a local anaesthetic is used (a local anaesthetic being a drug that acts at the sight which it is administered.”
Dr. Higgins furthered explained that the local anaesthetic blocks the nerve and by doing this movement and sensation of pain would be prevented to facilitate surgeries being done.
When questioned about cases in which a lumbar plexus sciatic nerve block cannot be done, the doctor revealed that there are very few cases in which this procedure cannot be applied. Among these cases are if the patient is allergic to the local anaesthetic agent, has an infection at the site of the block, or has bleeding disorders and/or sepsis.
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