The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution

Abstract

The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution Summary two groups are significant in all the tested areas, as well as the comparisons between 30 and 40 mL groups Ninety patients undergoing scheduled upper limb in the areas innervated by radial and musculoorthopaedic surgery were studied to determine the cutaneous nerves. Only the area innervated by the optimal anaesthetic dose using the 'orthogonal twoaxillary nerve showed a weaker volume-analgesia reneedle technique'. The patients were randomly aslation, confirming the elusiveness of this area to ansigned to one of three groups to receive one of three aesthesia in the axillary approaches. The improved different volumes (20, 30 and 40mL) (n=30) of results observed using greater amounts of anaesthetic anaesthetic solution (a mixture of equal parts of 0.5% solution might result from a higher intrasheath presbupivacaine with adrenaline 1:200 000 and 2% ligsure with disruption of sheath septa, or from a greater nocaine). A significant correlation was found between availability of drug for all the terminal branches of the volume injected and the anaesthetic spread for all brachial plexus, or both. tested areas. A better analgesic spread to all the major branches of the plexus was obtained when increased

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

“…It is still not clear whether a higher volume of local anaesthetic drug for establishment of axillary brachial plexus block is associated with a higher clinical success rate [17] or not [13]. The small variation in our mean relative dose of mepivacaine is mainly the result of our routine of using a total volume of 50 ml of mepivacine 10 mg )/ml (1 for this block in most adult patients.…”

Ultrasonographic guided axillary plexus blocks with low volumes of local anaesthetics: a crossover volunteer study

“…It shortens sensory onset times [2, 3], improves the quality and the duration of blocks [2, 4], may avoid complications (e.g. intraneuronal punctures, inadvertent vessel punctures, pneumothorax during periclavicular brachial plexus blocks) and enables a reduction of the volume of local anaesthetic due to precise administration of the local anaesthetic solution [5–11].…”

Does Local Anesthetic Dilution Influence the Clinical Effectiveness of Multiple-Injection Axillary Brachial Plexus Block?

“…3,5 While for the same dose of local anesthetic, larger volumes generally provided a better quality sensory block than did smaller ones, most of the evidence comes from early studies using paresthesia techniques for large volumes. 6,7 To our knowledge, only 1 study has tested how injecting local anesthetic at a fixed dose but at different volumes influences brachial plexus block onset times, 8 but inadequate statistical power prevented the investigators from drawing definitive conclusions about changes in block success rate. Having this information would be clinically useful because it might clarify whether the common practice of increasing the dilution volume of a fixed dose of local anesthetic induces a parallel increase in the axillary block success rate.…”