Bloqueio costoclavicular guiado por ultrassonografia como alternativa para anestesia de membro superior em paciente obeso

Silva, Grazielle Rodrigues; Borges, Danielle Gonçalves; Lopes, Iuri Ferreira; Ruzi, Roberto Araújo; Costa, Paulo Ricardo Rabello de Macedo; Mandim, Beatriz Lemos da Silva

doi:10.1016/j.bjan.2019.01.004

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…Though the costoclavicular approach has been a recent nomenclature, proximal, medial, vertical approaches essentially describe the same location and there have been multiple studies evaluating the block characteristics of these approaches. 9,11,15,25 Results from past studies comparing the two techniques have been equivocal. Some technical reports have led us to believe that medial approaches may be better and quicker for infraclavicular block.…”

Section: Discussionmentioning

confidence: 99%

“…8 Several researchers have suggested that the cords and needle may be easier to visualize with less needle manipulation during the procedure, potentially resulting in a faster onset of the block and a lower incidence of complications. [9][10][11][12] The primary aim of this study was to compare the block onset time of the novel costoclavicular (CC) with the conventional paracoracoid (PC) approach to the infraclavicular brachial plexus. We undertook a randomized controlled trial to compare the block onset time with both techniques and to test the hypothesis that the CC approach was similar to the well-established traditional approach.…”

Section: Introductionmentioning

confidence: 99%

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Paracoracoid versus Costoclavicular Approach to Infraclavicular Block: A Prospective, Two Arm, Parallel design, Single-centre Randomized Controlled Trial

Brown

Magsaysay

Bureau

et al. 2020

Preprint

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Introduction: Paracoracoid approach to the brachial plexus block is the conventional infraclavicular technique for upper limb surgeries. In this approach, the ultrasound transducer is placed in the parasagittal plane below the clavicle, medial to the coracoid process. In this view, three cords are separated from each other and are rarely visualized in a single ultrasound window. In the costoclavicular approach, the ultrasound transducer is placed parallel to and below the clavicle. In this view, the cords are clustered together, at a more superficial level. We conducted a randomized controlled trial to compare these two infraclavicular brachial plexus approaches. Methods: Seventy patients were randomized to receive either a paracoracoid or costoclavicular infraclavicular block. Both groups received 35 ml of 0.5% ropivacaine under ultrasound guidance. The primary outcome was sensory block onset time while secondary outcomes included performance times, complications during block insertion (paresthesia, vascular puncture, pleural puncture), block failure, patient satisfaction, and postoperative complications. Telephone follow-up was done 24 h and 7 days later. Results: Sensory block onset time was significantly shorter in the paracoracoid group 18.7 (4.4) min versus 22.2 (6.2) min (p=0.045). Block success at 30 minutes was the same between both groups. There was no difference in any secondary outcomes. Conclusion: This randomized controlled trial demonstrated that the novel costoclavicular approach to the infraclavicular brachial plexus block had similar procedure time, block success and similar complication rates for upper limb surgery when compared to the traditional paracoracoid technique but resulted in longer sensory block onset time.

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Section: Discussionmentioning

confidence: 99%