Multiple-Injection Axillary Brachial Plexus Block: A Comparison of Two Methods of Nerve Localization–Nerve Stimulation Versus Paresthesia

Sia, Salvatore; Bartoli, Maurizio; Lepri, Andrea Cozzi; Marchini, Osea; Ponsecchi, Paolo

doi:10.1213/00000539-200009000-00028

Cited by 76 publications

(35 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They indicated that this is because the low lipid affinity of ropivacaine quickens its dissociation from neural tissue, thus shortening the effect duration. Conversely, the low lipid affinity of ropivacaine to the external neural lipid quickens its transition to nerve action sites, thus resulting in rapid blocking effects [18]. The results of the present study were in agreement with these reports.…”

Section: Discussionsupporting

confidence: 93%

Relative Nerve Blocking Properties of Bupivacaine and Ropivacaine in Dogs Undergoing Brachial Plexus Block Using a Nerve Stimulator

et al. 2009

View full text Add to dashboard Cite

ABSTRACT. In the present study, the efficacy of a nerve stimulator in performing brachial plexus block (BPB) in dogs was investigated. The nerve blocking effects of bupivacaine and ropivacaine for BPB were also compared. Twelve beagles were allocated to groups based on the following treatments: conventional BPB with 0.5% bupivacaine (0.5% BupiM group) or BPB with 0.5% bupivacaine, 0.5% ropivacaine or 0.75% ropivacaine and a nerve stimulator (the 0.5% BupiS, 0.5% RopiS and 0.75% RopiS groups, respectively). After BPB, nerve blocking effects were assessed based on sensory blockade in several cutaneous areas and knuckling. The ratio of full block (blockade in all cutaneous areas) for 0.5% BupiM was 25%, and that for 0.5% BupiS was significantly higher, 75% (p<0.05). For the 0.5% BupiS, 0.5% RopiS and 0.75% RopiS groups, the average duration of full block was 387, 184 and 275 min, respectively, and the average duration of knuckling was 703, 460 and 421 min, respectively. The duration of full block and knuckling for the two ropivacaine groups was shorter compared with that of the 0.5% BupiS group. In conclusion, when using bupivacaine and ropivacaine for BPB in dogs, it is worth noting that there are differences in onset time and duration and that effective perioperative analgesia can be achieved depending on the intended use.KEY WORDS: brachial plexus block, bupivacaine, canine, nerve stimulator, ropivacaine.

show abstract

Section: Discussionsupporting

confidence: 93%

Relative Nerve Blocking Properties of Bupivacaine and Ropivacaine in Dogs Undergoing Brachial Plexus Block Using a Nerve Stimulator

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Clinical studies of axillary block have demonstrated that higher block success is achieved with triple stimulation (median, radial and musculocutaneous nerves) than with single or double stimulation techniques. 21,22 Anatomic studies also show the presence of septae within the axillary sheath which are thought to act as a diffusion barrier to local anesthetic spread. 23 Although visualization of septae is beyond the resolution of the ultrasound equipment we used, it is possible to observe the extent of local anesthetic spread in the axillary compartment under ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound guidance improves success rate of axillary brachial plexus block

Chan

Perlas

McCartney

et al. 2007

Can J Anesth/J Can Anesth

344

168

View full text Add to dashboard Cite

Purpose: The purpose of this study is to determine if real time ultrasound guidance improves the success rate of axillary brachial plexus blockade. Methods:Patients undergoing elective hand surgery were randomly assigned to one of three groups. Axillary blocks were performed using three motor response endpoints in the nerve stimulator (NS) Group, real-time ultrasound guidance in the ultrasound (US) Group and combined ultrasound and nerve stimulation in the USNS Group. Following administration of a standardized solution containing 2% lidocaine with 1:200,000 epinephrine and 0.5% bupivacaine (total 42 mL), sensory and motor functions were assessed by a blinded observer every five minutes for 30 min. A successful block was defined as complete sensory loss in the median, radial and ulnar nerve distribution by 30 min. The need for local and general anesthesia supplementation and post-block adverse events were documented. Results:One hundred and eighty-eight patients completed the study. Block success rate was higher in Groups US and USNS (82.8% and 80.7%) than Group NS (62.9%) (P = 0.01 and 0.03 respectively). Fewer patients in Groups US and USNS required supplemental nerve blocks and/or general anesthesia. Postoperatively, axillary bruising and pain were reported more frequently in Group NS. Conclusion: This study demonstrates that ultrasound guidance, with or without concomitant nerve stimulation, significantly improves the success rate of axillary brachial plexus block. EG et EGNS (82,8 % et 80,7 %) que dans le groupe NS (62,9 %) (P = 0,01 et 0,03 respectivement Méthode : Des patients devant subir une chirurgie élective de la main ont été randomisés en trois groupes. Des blocs axillaires ont été effectués en utilisant : trois points de réponses motrices dans le groupe neurostimulateur (NS), l'échoguidage en temps réel dans le groupe échographie (EG), et l'échographie combinée à la stimulation nerveuse dans le troisième groupe (EGNS

show abstract

“…3 Several advantages have been claimed with this technique, including a higher success rate, the avoidance of vascular injury, and the avoidance of paresthesias and associated neurological injury. [4][5][6] These clinical data are further strengthened by recent animal studies in which stimulating needles were inserted into the nerves under direct vision, yet the electrical current required to achieve a motor response could exceed 1mA. 7 Modern ultrasound machines are capable of imaging individual roots to their cords in the infraclavicular region.…”

mentioning

confidence: 99%

Comparative study between nerve stimulator guided technique and ultrasound guided technique of supraclavicular nerve block for upper limb surgery

et al. 2016

View full text Add to dashboard Cite

Multiple-Injection Axillary Brachial Plexus Block: A Comparison of Two Methods of Nerve Localization–Nerve Stimulation Versus Paresthesia

Cited by 76 publications

References 14 publications

Relative Nerve Blocking Properties of Bupivacaine and Ropivacaine in Dogs Undergoing Brachial Plexus Block Using a Nerve Stimulator

Relative Nerve Blocking Properties of Bupivacaine and Ropivacaine in Dogs Undergoing Brachial Plexus Block Using a Nerve Stimulator

Ultrasound guidance improves success rate of axillary brachial plexus block

Comparative study between nerve stimulator guided technique and ultrasound guided technique of supraclavicular nerve block for upper limb surgery

Contact Info

Product

Resources

About