Volume and Dose of Local Anesthetic Necessary to Block the Axillary Brachial Plexus Using Ultrasound Guidance

Hadžić, Admir; Dewaele, Steven; Gandhi, Kishor; Santos, Alan C.

doi:10.1097/aln.0b013e3181a913cc

Cited by 27 publications

(10 citation statements)

References 17 publications

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“…The publication by O’Donnell et al. is accompanied by an editorial from Hadzic, who speculates about the mechanism of such low volume blocks [27]. In particular, the possibility of intraneuronal injection needs to be stressed in that context.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…41 As this is in remarkable contrast with the volumes typically used for this block, 34,40 debates have ensued regarding whether this surprisingly low volume requirement was related to an ''uber-precise'' local anesthetic deployment, or even an intraneural injection. 42 Previous research has demonstrated that intraneural injections are not uncommon when ultrasound-guided axillary blocks are performed and do not necessarily result in nerve injury. 43 With respect to patients' comfort, 1 group reported that ultrasound guidance is superior to nerve stimulation; furthermore, an out-of-plane technique seems to be more comfortable that an in-plane ultrasound technique.…”

Section: Axillarymentioning

confidence: 99%

Outpatient Regional Anesthesia For Upper Extremity Surgery Update (2005 to Present) Distal to Shoulder

Maga

Cooper

Gebhard

2012

International Anesthesiology Clinics

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Multiple different approaches to the brachial plexus are available for the regional anesthesiologist to provide successful anesthesia and analgesia for ambulatory surgery of the upper extremity. Although supraclavicular and infraclavicular blocks are faster to perform than axillary blocks, the operator needs to keep in mind that blocks performed around the clavicle carry the risk for specific side effects and complications, no matter whether ultrasound or nerve stimulation is the chosen modality for neurolocation. Owing to the ambulatory nature of the planned surgical intervention, even significant side effects may not become clinically symptomatic until the patient is discharged from the facility. For example, due to pneumothorax risks, axillary or mid-humeral blocks remain the most logical approaches for ambulatory surgical procedures at and below the elbow, while reserving infra-clavicularor supraclavicular approaches for surgery from the proximal humerus to above the elbow. Smaller interventions such as carpal tunnel release or trigger finger release can be performed under elbow, wrist, or digital blocks. The regional anesthesiologist should strive to develop a tailored plan for each individual case to provide the most effective and safest nerve block technique for their patients.

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“…2 ilustra a correlação entre as probabilidades de sucesso e as concentrações observadas. O tempo de médio de latência, considerando todos os pacientes do estudo, foi de 15 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) minutos. Quando considerado apenas os pacientes que receberam bloqueios com a concentração de 0,25% (a concentração mais pró-xima da CME90), o tempo médio de latência foi de 20 (15)(16)(17)(18)(19)(20)(21)(22)15) minutos.…”

Section: Resultsunclassified

“…6---11 No entanto, a aplicabilidade clínica de baixos volumes e a limitação de se identificar injeções intraneurais pelo ultrassom têm sido questionadas. 12 Reduzir a concentração de anestésico local pode limitar a dose total do fármaco administrado sem alterar o volume injetado. Entretanto, a concentração mínima de anestésicos locais para se obter o BPVA com segurança, mas sem comprometer a qualidade do bloqueio e sua eficácia, ainda não foi estabelecida.…”

Section: Introductionunclassified

Concentração mínima efetiva de bupivacaína para o bloqueio do plexo braquial via axilar guiado por ultrassom

Takeda

Ferraro

Rezende

et al. 2015

Brazilian Journal of Anesthesiology

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Volume and Dose of Local Anesthetic Necessary to Block the Axillary Brachial Plexus Using Ultrasound Guidance

Cited by 27 publications

References 17 publications

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

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

Outpatient Regional Anesthesia For Upper Extremity Surgery Update (2005 to Present) Distal to Shoulder

Concentração mínima efetiva de bupivacaína para o bloqueio do plexo braquial via axilar guiado por ultrassom

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