A Prospective, Randomized Comparison Between Perivascular and Perineural Ultrasound-Guided Axillary Brachial Plexus Block

Bernucci, Francisca; González, Andrea P.; Finlayson, Roderick J.; Tran, De Q.H.

doi:10.1097/aap.0b013e3182576b6f

Cited by 69 publications

(109 citation statements)

References 10 publications

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“…The execution time is not affected by the method used to perform the block, the values obtained in this respect for the two groups of patients being very close and with no significant difference. Moreover, the literature shows similar results; a study conducted in 2012 obtained similar results when using the ultrasound method for axillary brachial plexus block -12.2 minutes [8] and another study, again in 2012, presented a performing time of 15.7 minutes [9].…”

Section: Discussionsupporting

confidence: 64%

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Lazăr

Janos

Iftenie

et al. 2017

Acta Medica Marisiensis

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Introduction: There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator. Objectives: The evaluation of ultrasound efficiency as an auxiliary method for brachial plexus block performance, in terms of success rate, vascular punctures. The influence of obesity on performing time, total duration of the block, and success rate of brachial plexus block. Material and method: Prospective, randomized study which enrolled adult patients, scheduled for surgical emergency or elective surgical intervention on upper limb with brachial plexus block by axillary approach, using either the peripheral nerve stimulation or the ultrasound guidance. Results: We enrolled 160 patients, grouped in two sets-the ultrasound group= 82 patients (US) the neurostimulation group = 78 patients (NS). Vascular punctures were statistically significant different p= 0, 04. The success rate was not influenced by the obesity. Conclusions: Ultrasound guidance makes axillary brachial plexus block safer, we can recommend ultrasound guidance as routine for axillary brachial plexus block. The obese patient can beneficiate by both methods of brachial plexus blockage.

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Section: Discussionsupporting

confidence: 64%

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Lazăr

Janos

Iftenie

et al. 2017

Acta Medica Marisiensis

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“…Two recent studies have shown that two injections (one around the musculocutaneous nerve and another posterior to the axillary artery) provide an equivalent success rate than the identification and injection of each of the four major nerves. 30,31 In addition to reducing the time needed to perform the block, this technique requires the operator to identify only the musculocutaneous nerve, which greatly simplifies the technique (Fig. 9) (Videos 4a and 4b, available as ESM).…”

Section: Axillary Approachmentioning

confidence: 99%

“…Deux études récentes ont démontré que deux injections (une autour du nerf musculocutané et une seconde en postérieur de l'artère axillaire) procurent un aussi bon taux de succès que l'identification et l'injection de chacun des quatre nerfs majeurs. 30,31 En plus de réduire la durée de réalisation du bloc, cette technique nécessite uniquement l'identification du nerf musculocutané, simplifiant grandement la technique (Fig. 9), (Vidéos 4a et 4b, disponibles en matériel électronique supplémentaire).…”

Section: Approche Infraclaviculaireunclassified

Ultrasound-guided regional anesthesia for upper limb surgery

Nadeau

Lévesque

Dion

2013

Can J Anesth/J Can Anesth

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“…23 The AXB was performed according to a previously described technique. [24][25][26] All patients received 1.0% lidocaine-0.25% bupivacaine (obtained by mixing equal parts of 2% lidocaine and 0.5% bupivacaine) with epinephrine 5 lgÁmL -1 . A SonoSite M-Turbo TM US machine (SonoSite Inc, Bothell, WA, USA) and a 6-13 MHz linear US probe were used in all subjects.…”

Section: Résumémentioning

confidence: 99%

A randomized comparison between intravenous and perineural dexamethasone for ultrasound-guided axillary block

Aliste

Leurcharusmee

Engsusophon

et al. 2016

Can J Anesth/J Can Anesth

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Background This randomized double-blinded trial compared the effect of intravenous and perineural dexamethasone (8 mg) on the duration of motor block for ultrasound (US)-guided axillary brachial plexus block (AXB). Methods Patients undergoing upper limb surgery with US-guided AXB were randomly allocated to receive preservative-free dexamethasone (8 mg) via intravenous (n = 75) or perineural (n = 75) administration. The local anesthetic agent, 1% lidocaine -0.25% bupivacaine (30 mL) with epinephrine 5 lgÁmL -1 , was identical in all subjects. Operators and patients were blinded to the nature of the intravenous and perineural injectate. A blinded observer assessed the block success rate (i.e., a minimal sensorimotor composite score of 14 out of 16 points at 30 min), block onset time, as well as the presence of surgical anesthesia. Postoperatively, the blinded observer contacted all patients with successful blocks to record the duration of motor block (primary outcome), sensory block, and postoperative analgesia. Results No intergroup differences were observed in terms of success rate, surgical anesthesia, and block onset time. RésuméContexte Cette étude randomisée à double insu portant sur le bloc axillaire du plexus brachial par échoguidage a comparé l'effet de la dexaméthasone (8 mg) administrée par voie intraveineuse ou périneurale sur la durée du bloc moteur. Méthode Des patients subissant une chirurgie des membres supérieurs sous un bloc axillaire du plexus brachial réalisé par échoguidage ont été randomisés à recevoir une dose de dexaméthasone (8 mg) sans agent de conservation par administration intraveineuse (n = 75) ou périneurale (n = 75). L'anesthésique local était identique pour tous les patients de l'étude, lidocaïne 1% et bupivacaïne -0,25% (30 mL) avec 5 lgÁmL -1

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A Prospective, Randomized Comparison Between Perivascular and Perineural Ultrasound-Guided Axillary Brachial Plexus Block

Abstract: Perivascular and PN ultrasound-guided AXBs result in comparable success rates and total anesthesia-related times. Because of fewer needle passes and a shorter performance time, the PV technique provides a simple alternative for ultrasound-guided AXB.

Cited by 69 publications

References 10 publications

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Ultrasound-guided regional anesthesia for upper limb surgery

A randomized comparison between intravenous and perineural dexamethasone for ultrasound-guided axillary block

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