Double- vs. single-injection infraclavicular plexus block in the emergency setting

Fuzier, Régis; Fourcade, Olivier; Fuzier, V.; Albert, Natalie; Samii, Kamran; Michel, Olivier

doi:10.1017/s0265021506000329

Cited by 14 publications

(5 citation statements)

References 12 publications

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“…This can be reduced with dual injection technique as mentioned in fuzzier R et al study. 22 This study had some limitations. A single anesthesiologist performed all the blocks.…”

Section: Discussionmentioning

confidence: 92%

A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

Junghare¹,

Junghare²,

Jamkar³

et al. 2020

IJCA

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Peripheral nerve blocks (PNB) are getting significant recognition for intraoperative and publish operative pain control because of their distinct advantage over general anaesthesia anesthesia. There are different ways to a brachial plexus block. The coracoid infraclavicular approach is feasible in almost all patients. A prospective randomized control trial was performed to compare the clinical effect of infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. Sixty patients receiving upper limb orthopedic surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The supraclavicular brachial plexus block was performed using nerve locater and ultrasound technique with 40 ml of 0.5% bupivacaine 1.5 mg/kg, ligocaine 2% with adrenaline 4mg/kg and distilled water. This study observed which nerve types were stimulated, and scored the sensory and motor blockage. The quality of the block was assessed intra-operatively and postoperatively with modified Lovette rating scale and McGill's pain score. The duration of the sensory, motor block and the complications were assessed. The patient's satisfaction with the anesthetic technique was assessed after surgery. Conclusions: In our study we observed similar effect in both infraclavicular and supraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach as complications are fewer with infraclavicular approach but expertise is needed in infraclavicular block.

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“…This can be reduced with dual injection technique as mentioned in fuzzier R et al study. 22 This study had some limitations. A single anesthesiologist performed all the blocks.…”

Section: Discussionmentioning

confidence: 92%

A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

Junghare¹,

Junghare²,

Jamkar³

et al. 2020

IJCA

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“…En ciblant les nerfs, on évite l'effet volume parfois nécessaire à la diffusion des anesthésiques vers toutes les branches nerveuses pour un succès similaire voir supérieur des blocs. 13 Dans notre cas, le risque de surdosage était aussi accru par l'injection de lidocaïne réalisée lors des sutures au visage effectuées préalablement à la chirurgie orthopédi-que. La résorption sanguine est importante au niveau de ce site à cause de sa riche vascularisation et de la présence des plaies.…”

Section: Discussionunclassified

Case report: Bilateral femoral and sciatic regional anesthesia in a polytraumatized. patient

Tanoubi

Cuvillon

Nouvellon

et al. 2008

Can J Anesth/J Can Anesth

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Objectif : Nous présentons un cas d'anesthésie locorégionale bilatérale des deux membres inférieurs comme anesthésie principale, en mettant en relief les mesures d'atténuation de la toxicité liée aux doses importantes d'anesthésiques locaux né-cessaires.Éléments cliniques : Une femme de 32 ans, obèse (index de masse corporelle = 30,4 kg·m -2 ), présentait des fractures bimalléolaires aux deux membres inférieurs nécessitant des ostéosyn-thèses urgentes. À cause de fractures au niveau de la face, de l'odontoïde et du bassin ainsi que de l'obésité et de l'estomac plein, nous avons priorisé l'indication de blocs bilatéraux des membres inférieurs. Des blocs fémoral et sciatique des deux membres inférieurs ont été réalisés avec un mélange de ropivacaïne et de mépivacaïne, en laissant un intervalle de 210 min entre chaque membre. Des dosages sanguins des anesthésiques locaux utilisés ont été faits 80 min après les blocs du premier membre et 45 min après les blocs du second. Les niveaux plasmatiques de ropivacaïne et de mépivacaïne étaient inférieurs aux seuils de toxicité habituels. La patiente n'a présenté aucun signe de toxicité et la chirurgie a été complétée sans complication. Conclusion

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“…In the LS approach, the block needle is placed in the lateral infraclavicular fossa in the parasagittal plane, and a local anesthetic (LA) is injected around the second part of the axillary artery. Despite being a safe and effective technique, the LS approach may require multiple injections and the use of relatively large volumes of LA, since the cords are located deeply and separately from each other and have many anatomical variations [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

Lateral Sagittal Versus Costoclavicular Approaches for Ultrasound-Guided Infraclavicular Brachial Plexus Block: A Comparison of Block Dynamics Through A Randomized Clinical Trial

Dost¹,

Kaya²,

Üstün³

et al. 2021

Cureus

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In this study, our objective was to compare the lateral sagittal infraclavicular block (LS-ICB) with the costoclavicular infraclavicular block (CC-ICB) for ultrasound (US)-guided infraclavicular brachial plexus block in terms of block dynamics as well as patient and surgeon satisfaction levels. MethodsA total of 100 patients, falling under the American Society of Anaesthesiologists (ASA) I-III categories, who were aged 18-65 years and scheduled for elective forearm and hand surgery were enrolled in the study. The patients were randomly allocated to receive a US-guided LS-ICB or US-guided CC-ICB. The local anesthetic (LA) agent used (20-ml 0.5% bupivacaine) was identical in all subjects. The block performance time and the motor and sensory block onset times were determined to be the primary outcomes. ResultsThe block performance time and the sensory block onset time were shorter in the CC-ICB group compared to the LS-ICB group [median (interquartile range): three (2.5-3.3) vs. two (1.5-2.3) minutes, p: <0.001; five (4.4-6) vs. four (3.8-6) minutes, p = 0.022, respectively]. The number of needle redirections was lower in the CC-ICB [three (2.7-4) vs. two (one to two) times, p: <0.001]. The motor block onset time and the motor-sensory block times were similar in both groups. There were more patients with a complete sensory blockade at five and 10 minutes in the CC-ICB group than in the LS-ICB group (30% vs. 12%, p = 0.027; 66% vs. 26%, p: <0.001, respectively). No complications were observed with regard to both techniques, and patient and surgeon satisfaction levels observed were similar for both groups. ConclusionBased on our findings, the CC approach provided a shorter performance time and a faster onset of the sensory block compared to the LS approach. However, no complications were reported with respect to either technique, and similar patient and surgeon satisfaction levels were observed.

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Double- vs. single-injection infraclavicular plexus block in the emergency setting

Abstract: We conclude that only 30 mL of local anaesthetic seems to be sufficient to ensure a high level of success when performing an infraclavicular block with stimulation of both the musculocutaneous nerve and median, ulnar or radial nerve.

Cited by 14 publications

References 12 publications

A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

Case report: Bilateral femoral and sciatic regional anesthesia in a polytraumatized. patient

Lateral Sagittal Versus Costoclavicular Approaches for Ultrasound-Guided Infraclavicular Brachial Plexus Block: A Comparison of Block Dynamics Through A Randomized Clinical Trial

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