| Title | Ultrasound guidance improves success rate of axillary brachial plexus block: [L'echoguidage ameliore le taux de succes du bloc axillaire du plexus brachial]. | | Author(s) | Chan VW, Perlas A, McCartney CJ, Brull R, Xu D, Abbas S | | Institution | Toronto Western Hospital, Department of Anesthesia, 2MC- 405, 399 Bathurst St, Toronto, Ontario M5T 2S8, Canada. vincent.chan@uhn.on.ca. | | Source | Can J Anaesth 2007 Mar; 54(3):176-82. | | Abstract | 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. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 17331928 |
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