Efficacy and safety of axillary brachial plexus block for operations on the hand

Abstract

An axillary brachial plexus nerve block by a transarterial approach is commonly used to achieve regional anaesthesia for hand surgery. We designed a retrospective study to evaluate efficacy and safety of the technique for acute and elective operations. Anaesthetic records of 189 of all 5520 patients (1996-2000) who had axillary brachial plexus blocks for hand surgery were reviewed, and results compared with complications recorded in the anaesthetic register and in the hand surgery records. Successful axillary block was achieved in 5128/5520 (93%) of patients, according to anaesthetic charts, and primarily in 157/189 (83%), and after supplementation in 171/189 (90%), according to anaesthetic records. Four patients had a toxic drug reaction or axillary haematoma with a transient neurological deficit. Medical complications were recorded in the anaesthetic register in less than 0.7% of axillary brachial plexus procedures. Axillary brachial plexus block by a transarterial approach is effective and safe in hand surgery.

Pain relief after ambulatory hand surgery: A comparison between dexmedetomidine and clonidine as adjuvant in axillary brachial plexus block: A prospective, double-blinded, randomized controlled study

“…Consequently, typical features of this block include rapid onset, predictable and dense anesthesia along with its high success rate. [ 19 ] Local anesthetics alone for axillary brachial plexus block provide good operative conditions but have a shorter duration of postoperative analgesia. Hence, various drugs have been used as an adjuvant with local anesthetics in axillary plexus block to achieve quick, dense and prolonged block, but the results are either inconclusive or associated with side-effects.…”

Brachial Plexus Anaesthesia: A Comparative Study on Supraclavicular Subclavian Perivascular Technique with the Axillary Transarterial Technique with A Tourniquet

“…No significant (p>0.05) difference was found between two groups. Andersson et al showed conversion to general anaesthesia was required in 23 patients (12% of anaesthetic records) and in 18 patients (10%) this was because regional anaesthesia was said to be inadequate, which is higher with the present study 15 .…”

Quantitative Architecture of the Brachial Plexus and Surrounding Compartments, and Their Possible Significance for Plexus Blocks

“…Therefore, a total of 80 digital perpendicular reconstructions were created. In each of the images, by using E-MAC, the epineurial surface area was delineated, after which pixel counting revealed the surface area in mm 2 . When the continuity of the epineurium was not fully visible in one image, a rapid sequential display of consecutive images was used to identify the epineurium.…”

“…NERVE injury after regional anesthesia is a feared complication that can cause immediate or subacute shortterm neurologic deficits and pain sensations, which can last for weeks or even months. 1 Data about the inci-dence of nerve injury with the use of peripheral nerve blocks show a relatively small incidence, ranging from 0.02% 2,3 to 0.2% 4 for distal block (axillary nerve block) and from 0.03% 3 to 0.4% 5 in short-and severe long-term neurologic complications of proximal blocks (interscalene nerve block). In animal studies, persistent neurologic complications range from 0 to 5% after brachial plexus blocks, depending on the technique used.…”