Ultrasound and nerve stimulation-guided axillary block

Lopera-Velásquez, Luz María; Restrepo-Garces, Carlos Eduardo

doi:10.1016/j.rcae.2015.11.004

Cited by 2 publications

(2 citation statements)

References 49 publications

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“…ABPB has been shown to be a relatively easy block to perform [ 10 ], making it a frequently used nerve block for forearm and hand surgery [ 11 ]. After reviewing ABPB compared to other RA blocks, we performed a focused meta-analysis to evaluate the surgical anesthesia and efficacy of the US-guided ABPB compared to other US-guided approaches in providing RA for hand and wrist surgery.…”

Section: Introductionmentioning

confidence: 99%

Axillary Brachial Plexus Block Compared with Other Regional Anesthesia Techniques in Distal Upper Limb Surgery: A Systematic Review and Meta-Analysis

Nijs,

Hertogen,

Buelens

et al. 2024

JCM

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Background: Several regional anesthesia (RA) techniques have been described for distal upper limb surgery. However, the best approach in terms of RA block success rate and safety is not well recognized. Objective: To assess and compare the surgical anesthesia and efficacy of axillary brachial plexus block with other RA techniques for hand and wrist surgery. The attainment of adequate surgical anesthesia 30 min after block placement was considered a primary outcome measure. Additionally, successful block outcomes were required without the use of supplemental local anesthetic injection, systemic opioid analgesia, or the need to convert to general anesthesia. Methods: We performed a systematic search in the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and CENTRAL. RCTs comparing axillary blocks with other brachial plexus block techniques, distal peripheral forearm nerve block, intravenous RA, and the wide-awake local anesthesia no tourniquet (WALANT) technique were included. Results: In total, 3070 records were reviewed, of which 28 met the inclusion criteria. The meta-analysis of adequate surgical anesthesia showed no significant difference between ultrasound-guided axillary block and supraclavicular block (RR: 0.94 [0.89, 1.00]; p = 0.06; I2 = 60.00%), but a statistically significant difference between ultrasound-guided axillary block and infraclavicular block (RR: 0.92 [0.88, 0.97]; p < 0.01; I2 = 53.00%). Ultrasound-guided infraclavicular blocks were performed faster than ultrasound-guided axillary blocks (SMD: 0.74 [0.30, 1.17]; p < 0.001; I2 = 85.00%). No differences in performance time between ultrasound-guided axillary and supraclavicular blocks were demonstrated. Additionally, adequate surgical anesthesia onset time was not significantly different between ultrasound-guided block approaches: ultrasound-guided axillary blocks versus ultrasound-guided supraclavicular blocks (SMD: 0.52 [−0.14, 1.17]; p = 0.12; I2 = 86.00%); ultrasound-guided axillary blocks versus ultrasound-guided infraclavicular blocks (SMD: 0.21 [−0.49, 0.91]; p = 0.55; I2 = 92.00%). Conclusions: The RA choice should be individualized depending on the patient, procedure, and operator-specific parameters. Compared to ultrasound-guided supraclavicular and infraclavicular block, ultrasound-guided axillary block may be preferred for patients with significant concerns of block-related side effects/complications. High heterogeneity between studies shows the need for more robust RCTs.

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Section: Introductionmentioning

confidence: 99%

Axillary Brachial Plexus Block Compared with Other Regional Anesthesia Techniques in Distal Upper Limb Surgery: A Systematic Review and Meta-Analysis

Nijs,

Hertogen,

Buelens

et al. 2024

JCM

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“…Block of this plexus is a great anesthetic choice for upper extremity surgery. 5 The most familiar approach of brachial plexus block is the axillary approach, as it is easy to perform. This approach may also result in lower complications than the interscalene region approach, which can lead to the spinal cord or vertebral artery puncture, and the supraclavicular approach, which can cause pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

Axilary Block Ultrasound Guiding in Patient with Pseudoaneurysm Regio Brachii Sinistra pro Repair Pseudoaneurysm

Purnomo

Kasmantino

2022

JAP

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Background: An aneurysm may be a true aneurysm or a pseudoaneurysm. Pseudoaneurysm is defined as a defect in the arterial wall, making a connection between the lumen and the extraluminal space. The main etiology of brachial artery pseudoaneurysm is incidental arterial puncture during venous cannulation for hemodialysis. Case:: Anesthetic management was performed on a female patient 56 years old, body weight 45 kg, height 150 cm. The patient had other comorbidities such as hypertension, diabetes mellitus, chronic renal kidney with a diagnosis of left brachial pseudoanuerysm. Pro Pseudoanurysm repair surgery. The anesthetic technique uses axillary peripheral nerve block with ultrasound guiding. The duration of surgery is ± 120 minutes. After the operation, the patient was treated in the hospital ward. Conclusion: Choosing the most appropriate anesthetic technique for patients with renal impairment is necessary to maintain normovolemia and normotension in order to avoid unexpected complications. Using regional anesthetic technique for sympathetic nerve block may be favorable in these patients. With ultrasound guiding, the incidence of failure is lower, the time required is shorter, the latency is shorter, the blockade is longer, and the risk of accidental vascular puncture is lower so that vascular lesions are less likely.

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Ultrasound and nerve stimulation-guided axillary block

Cited by 2 publications

References 49 publications

Axillary Brachial Plexus Block Compared with Other Regional Anesthesia Techniques in Distal Upper Limb Surgery: A Systematic Review and Meta-Analysis

Axillary Brachial Plexus Block Compared with Other Regional Anesthesia Techniques in Distal Upper Limb Surgery: A Systematic Review and Meta-Analysis

Axilary Block Ultrasound Guiding in Patient with Pseudoaneurysm Regio Brachii Sinistra pro Repair Pseudoaneurysm

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