A Prospective, Randomized Comparison Between Single- and Double-Injection Ultrasound-Guided Infraclavicular Brachial Plexus Block

Tran, De Q.H.; Bertini, Pietro; Zaouter, Cédrick; Muñoz, Loreto; Finlayson, Roderick J.

doi:10.1097/aap.0b013e3181c7717c

Cited by 77 publications

(90 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In conclusion, and in accordance with previous work (7,15,16), no significant difference was observed in the success rates of the SI and multiple injection methods. However, the TI method for IBPB resulted in improved onset time and more complete sensory and motor blocks at 10 min compared with the SI method.…”

Section: Discussionsupporting

confidence: 80%

Comparison of single‑ and triple‑injection methods for ultrasound‑guided interscalene brachial plexus blockade

Wang

Gao

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

Abstract. Ultrasound-guided interscalene brachial plexus blockade (IBPB) has a relatively high success rate in shoulder surgery; however, whether multiple injections are superior to a single injection (SI) is currently unknown. In the present study, ultrasound-guided SI and triple-injection (TI) IBPBs were compared in a prospective randomized trial. A total of 111 patients undergoing arthroscopic shoulder surgery and presenting with an American Society of Anesthesiologists physical status grading of I-II were randomly allocated to receive IBPB with 15 ml of 1% ropivacaine as a SI or TI. Performance time, procedure-related pain scores, success rate and prevalence of complications were recorded. The distribution of sensory and motor block onset in the radial, median, ulnar and axillary nerves were assessed every 5 min until 30 min post-local anesthetic injection. The duration of sensory and motor blocks were also assessed. A significantly longer performance time was recorded in the TI group (P<0.001). No significant difference was observed in success rate (91% in TI vs. 88% in SI) 30 min post-injection, and the prevalence of complications and procedure-related pain were similar between the two groups. Sensory and motor blocks of the ulnar nerve in the TI group were significantly faster and more successful compared with the SI group at all time points (P<0.041). It was also observed that sensory and motor blocks in the TI group were prolonged compared with the SI group (P<0.041). In conclusion, the TI method exhibited a faster time of onset and resulted in a more successful blockade of the ulnar nerve. TI method may be a more effective approach for IBPB in a clinical setting. IntroductionBlockade of the brachial plexus through an interscalene approach has a relatively high success rate in shoulder surgery (1-3). Ultrasound imaging of the brachial plexus between the anterior and middle scalene muscles is feasible (4), and it has been documented that use of ultrasound improves the success rate and reduces the prevalence of complications (5). Furthermore, the site of injection may affect the spread of local anesthetic (LA) (6), and a number of studies comparing different approaches for nerve blocks have documented that multiple injections of LA around the nerve result in a higher prevalence of success and a shorter time of onset compared with LA deposition at a single location (7-9). Furthermore, the present authors have previously observed that triple injection (TI) is necessary if LA is deposited inside the paraneural sheath, and that the paraneurium ʻentrapsʼ LA molecules, thereby ensuring circumferential spread around the interscalene brachial plexus nerve (7). Therefore, ultrasound-guided TI may increase the efficacy and quality of interscalene brachial plexus blocks (IBPBs).In the present study, a prospective, randomized, observerblinded trial was conducted to compare the efficacy and safety of single injection (SI) and TI methods of IBPB for arthroscopic shoulder surgery. The primary aims were to compare the on...

show abstract

Section: Discussionsupporting

confidence: 80%

Comparison of single‑ and triple‑injection methods for ultrasound‑guided interscalene brachial plexus blockade

Wang

Gao

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…28 Several clinical studies have confirmed this hypothesis. 20,29 A fascial click is felt just before reaching the posterior aspect of the artery and signals that the needle tip is in the right location. 20 For the technique to be successful, a U-shaped spread posterior to the artery (i.e., the artery being pushed anteriorly by the local anesthetic) should be …”

Section: Infraclavicular Approachmentioning

confidence: 99%

“…Plusieurs études cliniques ont confirmé cette hypothèse. 20,29 Un clic fascial est ressenti juste avant d'arriver en postérieur de l'artère et signe que la pointe de l'aiguille est au bon endroit. 20 Pour un bon succès, dès les premiers millilitres injectés, il faut observer une distribution en U en postérieur de l'artère, qui se fait repousser en antérieur par l'anesthésique local (Figs.…”

Section: Approche Infraclaviculaireunclassified

Ultrasound-guided regional anesthesia for upper limb surgery

Nadeau

Lévesque

Dion

2013

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…For verifying the position of injection needle about sciatic nerve, the methods of paresthesia search and electric stimulation of peripheral nerves were applied [1]. Use of ultrasound-guided regional anesthesia increases efficiency up to 96% -100% [2][3][4]. With the development of new technologies, new methods of verifying the position of injection needle about a nerve appeared which can evaluate the characteristics of local anesthetic spreading in such kind of peripheral blocks, as stellate ganglion block [5].…”

Section: Introductionmentioning

confidence: 99%

Features and Principles the Spread of Local Anesthetic Blockade of the Sciatic Nerve at Depends on the Amount of Anesthetic

Valery¹,

Aliaksei²

2014

OJAnes

View full text Add to dashboard Cite

Aim: To study the features of local anesthetic solution spreading during sciatic nerve block in dependence on the anesthetic solution volume. Material and Methods: One hundred and sixty nine cases of sciatic nerve blocks done under ultrasonic visualization control were analyzed. Sciatic nerve blocks were performed by lidocaine in volumes 30; 25; 20; 15; 12.5; 10; 7.5; 6.5; 5; 4.5 ml. The cross-section area, equal to local anesthetic spreading, was determined; the extension of the anesthetic solution spreading along sciatic nerve was calculated. Results: The anesthetic agent solution spreads along sciatic nerve in proximal and distal direction, forming a kind of cylinder. The minimum volume of the local anesthetic, which covers sciatic nerve in the whole, is 5 ml. A rare (1.77%) variation of sciatic nerve structure was described, in which tibial and common peroneal nerves develop directly from the branches of sacral plexus. Conclusion: The decrease of the local anesthetic volume leads to reduction of its spreading distance and cross-section area. Ultrasonic visualization can provide for sciatic nerve anatomical peculiarities, which can have an effect on the block quality.

show abstract

A Prospective, Randomized Comparison Between Single- and Double-Injection Ultrasound-Guided Infraclavicular Brachial Plexus Block

Abstract: The double-injection ultrasound-guided infraclavicular block provides no significant advantages compared with its single-injection counterpart.

Cited by 77 publications

References 8 publications

Comparison of single‑ and triple‑injection methods for ultrasound‑guided interscalene brachial plexus blockade

Comparison of single‑ and triple‑injection methods for ultrasound‑guided interscalene brachial plexus blockade

Ultrasound-guided regional anesthesia for upper limb surgery

Features and Principles the Spread of Local Anesthetic Blockade of the Sciatic Nerve at Depends on the Amount of Anesthetic

Contact Info

Product

Resources

About