Comparative Effectiveness of Infraclavicular and Supraclavicular Perineural Catheters for Ultrasound‐Guided Through‐the‐Catheter Bolus Anesthesia

Harrison, T. Kyle; Kim, T. Edward; Howard, Steven K.; Funck, Natasha; Wagner, Michael J.; Walters, Tessa L.; Curtin, Catherine; Mariano, Edward R.

doi:10.7863/ultra.34.2.333

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…1,2) In conventional catheter therapies using X-rays, 3,4) a metal guide wire of at least 400 µm diameter is used. Because of the need of a thin catheter of 200-300 µm diameter, [5][6][7][8] we have experimented on the bending of a thin catheter with an acoustic radiation force, 9,10) which is generated when an acoustic energy density gap occurs along the ultrasound propagation direction. [11][12][13][14] The production of an acoustic radiation force was carried out through studies to control microbubbles, [15][16][17][18][19] nanobubbles, 20) and cells 21,22) using an artificial blood vessel for future use in drug delivery systems.…”

Section: Introductionmentioning

confidence: 99%

Bending of thin catheter by tempo-spatial division of ultrasound emission and evaluation of viscosity effect

Ushimizu¹,

Suzuki²,

Mochizuki³

et al. 2018

Jpn. J. Appl. Phys.

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We have already experimented on the bending of a thin catheter with acoustic radiation force. Considering future in vivo applications, it is necessary to develop a method of bending a catheter in an arbitrary direction to adopt a limited installation position of ultrasound transducers on a body surface. Therefore, using a two-dimensional array transducer (256 elements, 1 MHz), which realizes not only the spatial design but also the dynamic variation of an acoustic field, we realized the bending of a thin catheter by forming multiple focal points. However, since the acoustic energy is dispersed with the multiple focal points, it was difficult to obtain sufficient displacement. Therefore, we attempted to bend the thin catheter with tempo-spatial division emission of a single focal point. Also, we compared the effect of the medium of not only water but also viscous liquid, which has similar viscosity to blood, where the bending performance of the catheter in the viscous liquid was reduced compared with that in water. Then, we derived the appropriate condition to bend the catheter with the transition rate of the focal point of 2.0 mm/s, and the spatial interval between 0.2 and 1.0 mm through various experimental trials. Finally, we succeeded in holding the tip of the catheter with the maximum displacement.

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Section: Introductionmentioning

confidence: 99%

Bending of thin catheter by tempo-spatial division of ultrasound emission and evaluation of viscosity effect

Ushimizu¹,

Suzuki²,

Mochizuki³

et al. 2018

Jpn. J. Appl. Phys.

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show abstract

“…Marianao, et al in a randomized controlled trial, concluded that infraclavicular brachial plexus catheters provided superior analgesia when compared to supraclavicular brachial plexus catheters [28]. However, in another randomized control trial, no significant differences in sensory blockade, pain scores or satisfaction was reported between the two techniques [27]. In our case series, the decision was influenced in certain instances by accessibility (for example presence of a cervical collar limiting supraclavicular fossa access) and body habitus (for example a high body mass index making infraclavicular needle tip visualization more difficult).…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, it has been thought that the supraclavicular approach may offer some advantages in the quality of pain control, due to the more compact arrangement of the brachial plexus [27]. Infraclavicular approach is considered more appropriate for placing a perineural catheter, because local musculature provides a more firm hold on the catheter [2,28,29].…”

Section: Discussionmentioning

confidence: 99%

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

Sen¹

2017

Clin Med Rev Case Rep

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Study objective: Brachial plexus catheters are typically placed to provide regional anesthesia to the shoulder, arm, forearm, wrist and hand. However, there are risks associated with catheter placement including infection and local anesthetic toxicity. Study design:In this study we discuss five case scenarios where we felt bilateral brachial plexus blocks were appropriate and, if performed with caution, the benefits would outweigh the risks. Each of these patients suffered severe bilateral upper-extremity traumatic injuries, requiring multiple surgical procedures and debridement's while inpatient on the trauma service. These patients were chosen because of the need for pain control during their hospital stay, the appropriateness of these particular techniques, and a lack of absolute contraindications to these techniques. Conclusions:In carefully-selected patients, bilateral brachial plexus catheters can be used safely and effectively to control pain secondary to traumatic injuries to the upper extremities. These catheters are a potentially valuable tool as part of a multimodal pain control regimen, with the goal of achieving adequate pain management, while limiting opioid use.

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“…The complications included paresthesia, injection pain related to the procedure, phrenic nerve palsy, and once more Horner syndrome ( 58 ). One randomized trial additionally found patients who received SC blocks reported higher incidence of postoperative sleep disturbances relative to those who received the IC approach ( 59 ). Other RCTs have also illustrated a lower incidence of required supplemental anesthesia or subsequent block administration – thus reducing the incidence of procedural-related pain or paresthesia and reducing the number of required needle passes ( 57 , 60 , 61 ).…”

Section: Comparison Of Safety and Efficacy Of Supraclavicular Vs Infraclavicular Approachesmentioning

confidence: 99%

“…In this study, 88% of SC patients and 100% of IC patients achieved sensory block within 30 minutes with no significant differences in the time to complete the procedure. It was thus determined that both approaches provided an optimal block with no true significant differences between the approaches ( 59 ). In the second trial, 150 patients split into two groups (SC vs. IC) were given ropivacaine ultrasound-guided blocks, and the mean procedural time, sensory block achieved, and failure rate were similar.…”

Section: Comparison Of Safety and Efficacy Of Supraclavicular Vs Infraclavicular Approachesmentioning

confidence: 99%

Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations

et al. 2021

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: Peripheral nerve blocks (PNB) have become standard of care for enhanced recovery pathways after surgery. For brachial plexus delivery of anesthesia, both supraclavicular (SC) and infraclavicular (IC) approaches have been shown to require less supplemental anesthesia, are performed more rapidly, have quicker onset time, and have lower rates of complications than other approaches (axillary, interscalene, etc.). Ultrasound-guidance is commonly utilized to improve outcomes, limit the need for deep sedation or general anesthesia, and reduce procedural complications. Given the SC and IC approaches are the most common approaches for brachial plexus blocks, the differences between the two have been critically evaluated in the present manuscript. Various studies have demonstrated slight favorability towards the IC approach from the standpoint of complications and safety. Two prospective RCTs found a higher incidence of complications in the SC approach – particularly Horner syndrome. The IC method appears to support a greater block distribution as well. Overall, both SC and IC brachial plexus nerve block approaches are the most effective and safe approaches, particularly under ultrasound-guidance. Given the success of the supraclavicular and infraclavicular blocks, these techniques are an important skill set for the anesthesiologist for intraoperative anesthesia and postoperative analgesia.

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Comparative Effectiveness of Infraclavicular and Supraclavicular Perineural Catheters for Ultrasound‐Guided Through‐the‐Catheter Bolus Anesthesia

Abstract: Both supraclavicular and infraclavicular perineural catheters using a through-the-catheter bolus technique provide effective brachial plexus anesthesia.

Cited by 14 publications

References 30 publications

Bending of thin catheter by tempo-spatial division of ultrasound emission and evaluation of viscosity effect

Bending of thin catheter by tempo-spatial division of ultrasound emission and evaluation of viscosity effect

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

Supraclavicular vs. Infraclavicular Brachial Plexus Nerve Blocks: Clinical, Pharmacological, and Anatomical Considerations

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