Low dose axillary block by targeted injections of the terminal nerves

Koscielniak-Nielsen, Zbigniew J.; Nielsen, Per Peetz; Sørensen, Tommy; Stenør, Michael

doi:10.1007/bf03013954

Cited by 45 publications

(30 citation statements)

References 19 publications

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“…80 Although multiple stimulations require more time, readiness for surgery may actually be faster. 66,67,81 Lastly, the specific nerves sought, not just their number, may be clinically relevant. Although the ideal nerves to stimulate vary, 75,80,82 the ulnar nerve appears to be the least important.…”

Section: Single Versus Multiple Injections For Axillary Blockmentioning

confidence: 99%

Brachial plexus anesthesia: Essentials of our current understanding☆

Neal

Hebl

Gerancher

et al. 2002

Regional Anesthesia and Pain Medicine

167

156

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Section: Single Versus Multiple Injections For Axillary Blockmentioning

confidence: 99%

Brachial plexus anesthesia: Essentials of our current understanding☆

Neal

Hebl

Gerancher

et al. 2002

Regional Anesthesia and Pain Medicine

167

156

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“…A number of articles have shown that pain at the time of peripheral nerve block is mostly associated with multiple electrolocalizations or injections. [15][16][17] Sia et al 18 reported that the cause of major pain at the time of the procedure was the withdrawal and repositioning of the needle, whereas Standl and Burmeister 19 correlated patient dissatisfaction with repeated muscle contractions and needle movements. In a study of peripheral block performed on 3996 patients using PNS, a high success rate of up to 94% was obtained; however, 74% of the patients said that they would prefer a different anaesthetic method next time, mainly due to discomfort during performance of the block.…”

Section: Discussionmentioning

confidence: 99%

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

et al. 2014

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Objective: The effectiveness of axillary brachial plexus block (ABPB) performed using peripheral nerve stimulation (PNS) alone was compared with PNS preceded by nerve localization using a pen device, enabling nerve mapping without puncturing the skin. Methods: Patients undergoing unilateral hand or forearm surgery suitable for ABPB were randomly assigned to receive either PNS alone (pen À group) or PNS preceded by nerve localization using a pen device (pen þ group). Parameters related to the block procedure and patient comfort were assessed. Results: Thirty patients were included in each group. The block performance time was longer in the pen þ group than the pen À group despite a reduced number of needle insertions. The complete block rate was higher and intraoperative analgesic usage lower in the pen þ group compared with the pen À group. Patient satisfaction and complication rates were similar in the two groups. Conclusion: The pen device seems to be a helpful addition to PNS for ABPB, with improved results in terms of block success and patient comfort, but further studies are needed to confirm these findings.

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“…Rapid development of the block and early readiness for surgery can be obtained when LA injections are in close proximity to the nerves. 43 Study I and III showed consistent block effect after 50 min for both the single-and the tripledeposit method by clinical assessment. The patients in the triple-deposit group had a block success of 92% in study I and 100% in study III.…”

Section: Validation Of Single-vs Multiple-deposit Block Methodsmentioning

confidence: 99%

Transarterial block as an addition to a conventional catheter technique improves the axillary block

Kjelstrup

2005

Acta Anaesthesiol Scand

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Background: We have had favourable experience with a triple injection technique, combining an axillary catheter technique with a transarterial axillary block. This method has been used successfully for routine surgery and re‐implantation of fingers, hand or forearm. We hypothesized that with this technique, block onset time and effectiveness are better than with a conventional catheter technique, and designed a study comparing this new technique with a conventional single injection through a catheter. Methods: Fifty‐one adult patients were included in a prospective study. In all patients, a short axillary plexus catheter was positioned close to the median nerve. All patients had an injection through the catheter, while 26 of the patients had an additional injection behind, and in front of, the axillary artery. Sensory and motor block were tested continuously every minute for 29 min. Block success was recorded as onset time to analgesia, anaesthesia and complete motor block in the first 29 min. At 30 and 50 min, an analgesia block score was recorded. Results: The transarterial injection plus catheter method was more effective, with a higher success rate and faster onset, than the catheter method. Readiness for surgery with analgesia in the median, radial and ulnar nerves was achieved in the catheter group in 13 patients (52%) at a mean time of 20.8 min, and in the combined group in 21 patients (81%) at a mean time of 13.3 min (P < 0.05, P < 0.05). At 50 min the situation was 17 (68%) and 24 (92%), respectively (P < 0.05). Conclusion: The combined triple injection is faster and more effective than the catheter method alone.

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Low dose axillary block by targeted injections of the terminal nerves

Cited by 45 publications

References 19 publications

Brachial plexus anesthesia: Essentials of our current understanding☆

Brachial plexus anesthesia: Essentials of our current understanding☆

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

Transarterial block as an addition to a conventional catheter technique improves the axillary block

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