A Randomized Comparison Between Double-Injection and Targeted Intracluster-Injection Ultrasound-Guided Supraclavicular Brachial Plexus Block

Techasuk, Wallaya; González, Andrea P.; Bernucci, Francisca; Cupido, Tracy; Finlayson, Roderick J.; Tran, De Q.H.

doi:10.1213/ane.0000000000000224

Cited by 45 publications

(58 citation statements)

References 16 publications

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“…1,4 Briefly, the supraclavicular fossa was scanned in a sterile fashion in search of a short-axis view of the subclavian artery. The main and satellite neural clusters were identified.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, we have described a new targeted intracluster injection (TII) technique for ultrasound (US)-guided supraclavicular brachial plexus blockade (SCB) whereby local anesthetic (LA) agents are deposited inside the main as well as the satellite neural clusters (i.e., trunks/divisions of the brachial plexus). 1 Compared to standard US-guided SCB, 2,3 we have shown that the TII technique resulted in a shorter total anesthesia-related time (i.e., the sum of block performance time and onset time to a minimal sensorimotor composite score of 14 out of 16 points) in 90 subjects undergoing elective or semi-elective (fracture repair) upper limb surgery. 1 In order to validate US-guided TII SCB, we also compared it with US-guided infraclavicular blocks in a similar study population of 64 subjects.…”

Section: Résumémentioning

confidence: 95%

“…1 Compared to standard US-guided SCB, 2,3 we have shown that the TII technique resulted in a shorter total anesthesia-related time (i.e., the sum of block performance time and onset time to a minimal sensorimotor composite score of 14 out of 16 points) in 90 subjects undergoing elective or semi-elective (fracture repair) upper limb surgery. 1 In order to validate US-guided TII SCB, we also compared it with US-guided infraclavicular blocks in a similar study population of 64 subjects. 4 Again, the TII SCB provided a shorter total anesthesia-related time.…”

Section: Résumémentioning

confidence: 95%

“…Nous avons également consigné le nombre de passages d'aiguilles, la douleur liée à la procédure et les complications (ponction vasculaire, paresthésies). Résultats La méthode du TII SCB a entraîné un délai moyen (É T) d'apparition de la réponse plus rapide que la méthode AXB (9,5 [5,8] minutes contre 18,9 [6,1] minutes; différence moyenne 9,5 minutes; IC à 99 %, -14,7 à -4,2; P \ 0,001]) et un temps total moyen (É T) lié à l'anesthésie plus court (20,1 [5,0] minutes contre 27,2 [6,5] minutes; différence moyenne 7,0 minutes; IC à 95 %, -10,9 à -3,1; P = 0,001). Il n'y a pas eu de différences entre les groupes pour ce qui concerne le taux de succès (95 %), la douleur de la procédure, les ponctions vasculaires et les paresthésies.…”

Section: Résuméunclassified

“…Il n'y a pas eu de différences entre les groupes pour ce qui concerne le taux de succès (95 %), la douleur de la procédure, les ponctions vasculaires et les paresthésies. Le groupe AXB a affiché un temps de réalisation plus court (8,2 [1,6] minutes contre 10,6 [2,6] minutes; P = 0,001] avec un moins grand nombre médian (intervalle interquartile) de passages d'aiguille (3 [2-6] contre 5 [4][5][6][7][8]; P = 0,001). Conclusion Le TII SCB échoguidé entraîne une apparition plus rapide et un temps total lié à l'anesthésie plus court que l'AXB échoguidé.…”

Section: Résuméunclassified

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A randomized trial comparing axillary block versus targeted intracluster injection supraclavicular block for upper limb surgery

Arnuntasupakul

Leurcharusmee

Garza

et al. 2015

Can J Anesth/J Can Anesth

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Purpose This randomized trial aimed to validate a new method for brachial plexus blockade, i.e., targeted intracluster injection supraclavicular block (TII SCB), by comparing it with ultrasound-guided axillary block (AXB). We hypothesized that TII SCB would result in a shorter total anesthesia-related time. Methods Forty patients undergoing upper limb surgery were randomized to ultrasound-guided TII SCB (n = 20) or AXB (n = 20). In the TII SCB group, we deposited 16 mL of lidocaine 1.5% with epinephrine 5 lgÁmL -1 into the largest neural cluster (i.e., brachial plexus trunks/divisions). Subsequently, an additional 16 mL was divided into equal aliquots and injected inside each satellite cluster. In the AXB group, 5.5 mL were deposited around the musculocutaneous nerve and 23.5 mL were injected at the 6 o'clock position of the axillary artery. The main outcome for comparison between the two groups was the total anesthesia-related time (defined as the sum of block performance and onset times). We also recorded the number of needle passes, procedural pain, and complications (vascular puncture, paresthesia). ResultsThe TII SCB method provided a quicker mean (SD) onset time compared with the AXB group [9.5 (5.8) min vs 18.9 (6.1) min; mean difference, -9.5 min; 99% CI, -14.7 to -4.2; P \ 0.001] and a shorter mean (SD) total anesthesia-related time [20.1 (5.0) min vs 27.2 (6.5) min; mean difference, -7.0 min; 95% CI, -10.9 to -3.1; P = 0.001]. There were no intergroup differences in terms of success rate (95%), procedural pain, vascular puncture and paresthesia. The AXB group displayed a faster performance time [8.2 (1.6) min vs 10.6 (2.6) min; P = 0.001] with fewer median [interquartile range] needle passes (3 [2-6] vs 5 [4-8]; P \ 0.001). Conclusion Ultrasound-guided TII SCB provides a quicker onset and a shorter total anesthesia-related time than ultrasound-guided AXB. RésuméObjectif Cette étude randomisée visait à valider une nouvelle méthode de bloc du plexus brachial, c'est-à-dire un bloc supraclaviculaire par injection ciblée intraplexique (TII SCB -targeted intracluster injection supraclavicular block), en la comparant au bloc axillaire échoguidé (AXB -ultrasound-guided axillary block). Nous avons émis l'hypothèse que le TII SCB entraînerait un temps d'anesthésie total plus court. Méthodes Quarante patients subissant une chirurgie du membre supérieur ont été randomisés pour avoir un TII SCB (n = 20) ou un AXB (n = 20) échoguidé. Dans le groupe TII SCB, nous avons injecté 16 mL de lidocaïne à 1,5 % avec 5 lgÁmL -1 d'épinéphrine dans le plus grand groupe nerveux (c'est-à-dire, les troncs et divisions du

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“…1,4 Briefly, the supraclavicular fossa was scanned in a sterile fashion in search of a short-axis view of the subclavian artery. The main and satellite neural clusters were identified.…”

Section: Methodsmentioning

confidence: 99%