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

A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve es s: : The aim of the study is to determine the duration of action and ideal effective doses of bupivacaine-lidocaine combination in different concentrations for infraclavicular brachial plexus block. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Patients were randomized into 3 groups, consisting of 20 patients and applied 15 mL 0.5% bupivacaine-15 mL 2% lidocaine to the first, 15 mL 0.5% bupivacaine-15 mL 2% lidocaine with 30 mL saline to the second, 10 mL 0.5% bupivakain-10 ml 2% lidocaine with 40 mL saline to the third group. Onset and duration of motor and sensory blocks, additional analgesic requirements, postoperative Visual Analogue Scale scores were recorded. R Re es su ul lt ts s: : Groups were similar according to demographics, time until operation after block, operation time, perioperative and postoperative mean arterial pressure, heart rates, SpO2 values. Initiation of sensory block time was significantly longer in Group 1 than the others. Motor block initiation time was significantly longer in Group 1 than the other groups. Postoperative sensory and motor block performance time was significantly shorter in Group 1 than the other groups. Additional analgesic requirement and Visual Analogue Scale scores were highest in Group 1 (p<0.05). C Co on nc cl lu us si io on n: : In the current study we observed that by increasing the volume of local anesthetic solution, the time for initiation of sensory and motor block decreases and the duration of both sensory and motor block increases. We concluded that using decreased amount of bupivacaine-lidocaine combination to 60 mL, may cover the surgery and is efficient for postoperative analgesia.K Ke ey y W Wo or rd ds s: : Anesthesia, conduction; orthopedic procedures; nerve block Ö ÖZ ZE ET T A Am ma aç ç: : Çalışmamızın amacı; infraklaviküler brakial pleksus blokajı ile gerçekleştirilen el cerrahisi operasyonlarında, farklı doz ve konsantrasyonlardaki Bupivakain-Lidokain kombinasyonlarının etkinlik sürelerini saptamak ve ideal ilaç dozunu belirlemektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hastalar randomize olarak üç gruba ayrıldı (n=20). Birinci gruba 15 ml % 0,5 Bupivakain-15 ml %2 Lidokain (Grup 1), ikinci gruba 15 ml % 0,5 Bupivakain-15 ml %2 Lidokain-30 ml serum fizyolojik (Grup 2), üçüncü gruba 10 ml % 0,5 Bupivakain-10 ml %2 Lidokain-40 ml serum fizyolojik uygulandı (Grup 3). Duysal ve motor blok başlangıç süresi, ek analjezik gereksinimleri, postoperatif Vizüel Analog Skala skorları kaydedildi. B Bu ul lg gu ul la ar r: : Gruplar demografik özellikler, blok sonrası operasyona başlama süresi, cerrahi süre, turnike süresi, peroperatif ve postoperatif ortalama arter basıncı, kalp tepe atımı ve SpO2 değerleri bakımından benzerdi. Grup 1'de duyusal blok başlama süresi diğer gruplardan anlamlı olarak daha uzundu. Grup 1'de motor blok başlama süresi diğer gruplardan anlamlı olarak daha uzundu. Ek analjezi ihtiyacı ve Vizüel Analog Skala skoru Grup 1'de en yüksekti (p<0,05). Grup...

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“…8 In this study, they concluded that success rate of blockade was higher in groups where 30 and 40 mL local anesthetic was administered.…”

Section: Discussionmentioning

confidence: 81%

“…In the current study, we used 30 mL and 60 mL local anesthetics in different concentrations. [8][9][10][11] Risk of systemic toxicity especially rises in case of advanced age, poor health, liver and kidney failure and pregnancy. Therefore, volume is kept as low as possible in the studies with the aim of achieving a successful blockade.…”

Section: 10mentioning

confidence: 99%

Comparison of Different Doses and Concentrations of Bupivacaine and Lidocaine Combination for Infraclavicular Brachial Plexus Block

Sevinç¹,

Saraçoğlu²,

Bezen³

et al. 2016

Turkiye Klinikleri J Anest Reanim

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“…In studies where local anesthetic agents more than 30 ml were used, better drug distribution in the axillary region with higher success rates have been demonstrated [22, 23]. Besides, as reported in the literature, local anesthetic agent applied lateral to the median nerve spreads along the axillary artery and easily blocks the musculocutaneous nerve [11, 13, 24].…”

Section: Discussionmentioning

confidence: 99%

Our experiences with a single injection axillary block technique

Yanli

Ozdemir

Bakan

2014

North Clin Istanbul

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OBJECTIVE:Axillary plexus block is one of the widely used technique for upper extremity surgery. In this study, we retrospectively evaluated the single injection axillary plexus block technique we used in our rutine anesthesia practice, between August 2010-March 2011.METHODS:Medical records of ASA I-III, 40 17 female and 23 male patients who underwent elective single injection axillary block performed by neurostimulation technique in elective distal part of the arm, forearm and hand surgeries were evaluated, retrospectively. Axillary block was performed with a nerve stimulator, and a 22 G, 50 mm insolated needle. The needle was inserted immediately superior to axillary artery, advanced through the lateral border of the pectoralis major muscle and to the most proximal part of the axilla. The local anesthetic mixture (1% lidocaine 20 ml + 0.25% bupivacaine 15 ml) was injected to the place (point) where the distal motor responses of the median and ulnar nerves were elicited at the same time, before dropping the stimulation current down to 0.5 mA. In our study, demographic data, motor and sensory block times, the success rate and the complications of the block were evaluated.RESULTS:The mean block performance time was 1.21±0.39 min in our 40 patients. The onset time of the motor block was 14.20±4.96 min and the sensory block was 17.19±2.71 min, respectively. The success rate of the block was 97.5 percent. No complication was found during 24 hours postoperatively. The sensory and motor functions returned properly in all patients.CONCLUSION:In our study we found that the single injection axillary block tecnique was easy to perform with its higher success, and lower complication rates. Therefore we concluded that axillary block should be supported in appropriate cases.

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

Marhofer

Eichenberger²,

Stockli

et al. 2010

Anaesthesia

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SummaryOur study group recently evaluated an ED 95 local anaesthetic volume of 0.11 ml.mm )2 crosssectional nerve area for the ulnar nerve. This prospective, randomised, double-blind crossover study investigated whether this volume is sufficient for brachial plexus blocks at the axillary level. Ten volunteers received an ultrasonographic guided axillary brachial plexus block either with 0.11 ('low' volume) or 0.4 ('high' volume) ml.mm )2 cross-sectional nerve area with mepivacaine 1%. The

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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

Cited by 3 publications

References 11 publications

Comparison of Different Doses and Concentrations of Bupivacaine and Lidocaine Combination for Infraclavicular Brachial Plexus Block

Comparison of Different Doses and Concentrations of Bupivacaine and Lidocaine Combination for Infraclavicular Brachial Plexus Block

Our experiences with a single injection axillary block technique

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

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