Comparison of nerve stimulator and ultrasonography application for brachial plexus anesthesia

Objective: Axillary brachial plexus block can be achieved through various techniques in upper extremity operations. The purpose of our study was to compare the efficacy of axillary brachial plexus block using an ultrasound technique with peripheral nerve stimulation technique.Material and Methods: Sixty patients for whom elective forearm and hand surgery was planned were included in the study. Group 1 (n=30) was given an axillary block by using ultrasonography, Group 2 (n=30) was given axillary block by using a peripheral nerve stimulator. The quality and time of onset of the sensorial and motor blockade were assessed.Results: The average time needed to perform the axillary brachial plexus block was similar in both groups. Although not significant statistically, it was observed that the sensory block was achieved earlier in Group 1. However, the degree of motor blockade was more intense in Group 1 than in Group 2.Conclusion: The ultrasound-guided axillary brachial plexus block is a preferable method with faster onset time and better quality of motor blockade compared to the PNS technique.

Comparison of nerve stimulator and ultrasonography application for brachial plexus anesthesia

Objective: Axillary brachial plexus block can be achieved through various techniques in upper extremity operations. The purpose of our study was to compare the efficacy of axillary brachial plexus block using an ultrasound technique with peripheral nerve stimulation technique.Material and Methods: Sixty patients for whom elective forearm and hand surgery was planned were included in the study. Group 1 (n=30) was given an axillary block by using ultrasonography, Group 2 (n=30) was given axillary block by using a peripheral nerve stimulator. The quality and time of onset of the sensorial and motor blockade were assessed.Results: The average time needed to perform the axillary brachial plexus block was similar in both groups. Although not significant statistically, it was observed that the sensory block was achieved earlier in Group 1. However, the degree of motor blockade was more intense in Group 1 than in Group 2.Conclusion: The ultrasound-guided axillary brachial plexus block is a preferable method with faster onset time and better quality of motor blockade compared to the PNS technique.

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  • 1. Casati A. Local Anesthetics. In: Chelly JE, Casati A, Fanelli G, editors. Continuous Peripheral Nerve Blocks: An Illustrated Guide. Milano: Mosby; 2001. p.37-44.
  • 2. Nielsen ZK. Axillary Brachial Plexus Block. In: Hadzic A, editor. Textbook of Regional Anesthesia and Acute Pain Management. New York: The McGraw-Hill; 2007. p.441-51.
  • 3. Wedel DJ, Horlocker TT. Nerve Blocks. In: Miller RD, editor. An-aesthesia 6th ed. Vol 2. New York: Churchill Livingstone; 2005. p.1685-95.
  • 4. Urmey WF. Upper Extremity Blocks. In: Brown DL, editor. Region-al Anesthesia and Analgesia. Philadelphia: W.B.Saunders Com-pany; 1996. p.266-8.
  • 5. Gray AT. Role of ultrasound in startup regional anesthesia prac-tice for outpatients. Int Anesthesiol Clin 2005;43:69-78.
  • 6. Lavoie J, Martin R, Tétrault JP, Côté DJ, Colas MJ. Axillary plexus block using a peripheral nerve stimulator: single or multiple injec-tions. Can J Anaesth 1992;39:583-6.
  • 7. Franco CD, Vieira ZE. 1,001.subclavian perivascular brachial plexus blocks: success with a nerve stimulator. Reg Anesth Pain Med 2000;25:41-6.
  • 8. Cheney FW, Domino KB, Caplan RA, Posner KL. Nerve injury associated with anesthesia: a closed claims analysis. Anesthesiology 1999;90:1062-9.
  • 9. Thompson GE, Rorie DK. Functional anatomy of the brachial plexus sheats. Anesthesiology 1983;59:117-22.
  • 10. Jage J, Kossatz W, Biscoping J, Zink KU, Wagner W. Axillary blockade of the brachial plexus using 60 ml prilocaine 0.5% vs. 40 ml prilocaine 1%. A clinical study of 144 patients carried out by the determination of the prilocaine concentration in the central venous blood and by the measurement of the subfascial pressure in the plexus following the injection. Reg Anaesth 1990;13:112-7.
  • 11. Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg 1999;88:847-52.
  • 12. Coventry DM, Barker KF, Thomson M. Comparison of two neurostimulation techniques for axillary brachial plexus blockade. Br J Anaesth 2001;86:80-3.
  • 13. Horlocker TT, Kufner RP, Bishop AT, Maxson PM, Schroeder DR. The risk of persistent paresthesia is not increased with repeated axillary block. Anesth Analg 1999;88:382-7.
  • 14. Baumgarten RK, Thompson GE. Is ultrasound necessary for routine axillary block? Reg Anesth Pain Med 2006;31:88-9.
  • 15. Li C, McCartney C, Perlas A, Chan V. Successful use of ultrasound guided axillary block in three morbidly obese patients. Reg Anesth Pain Med 2004;29(4 Suppl):S52.
  • 16. Schwemmer U, Schleppers A, Markus C, Kredel M, Kirschner S, Roewer N. Operative management in axillary brachial plexus blocks: comparison of ultrasound and nerve stimulation. Anaesthesist 2006;55:451-6.
  • 17. Schwemmer U, Markus CK, Greim CA, Brederlau J, Roewer N. Ultrasound-guided anaesthesia of the axillary brachial plexus: efficacy of multiple injection approach. Ultraschall Med 2005;26:114-9.
  • 18. Soeding PE, Sha S, Royse CE, Marks P, Hoy G, Royse AG. A randomized trial of ultrasound-guided brachial plexus anaesthesia in upper limb surgery. Anaesth Intensive Care 2005;33:719-25.
  • 19. Kefalianakis F, Spohner F. Ultrasound-guided blockade of axillary plexus brachialis for hand surgery. Handchir Mikrochir Plast Chir 2005;37:344-8.
  • 20. Liu FC, Liou JT, Tsai YF, Li AH, Day YY, Hui YL, et al. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method. Chang Gung Med J 2005;28:396-402.
  • 21. Liu FC, Lee LI, Liou JT, Hui YL, Lui PW. Ultrasound-guided axillary brachial plexus block in patients with chronic renal failure: report of sixteen cases. Chang Gung Med J 2005;28:180-5.
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
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