scholarly journals Ultrasound guidance improves success rate of axillary brachial plexus block

2007 ◽  
Vol 54 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Vincent W. S. Chan ◽  
Anahi Perlas ◽  
Colin J. L. McCartney ◽  
Richard Brull ◽  
Daquan Xu ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Ultrasound Guidance ◽  
Brachial Plexus Block ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block

scholarly journals Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

2017 ◽  
Vol 63 (3) ◽  
pp. 147-151
Author(s):  
Alexandra Lazar ◽  
János Szederjesi ◽  
Elena Iftenie ◽  
Leonard Azamfirei
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Ultrasound Guidance ◽  
Brachial Plexus Block ◽  
Total Duration ◽  
Low Risk ◽  
Axillary Approach ◽  
Axillary Brachial Plexus Block ◽  
Adjacent Structures ◽  
Plexus Block

AbstractIntroduction:There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator.Objectives: The evaluation of ultrasound efficiency as an auxiliary method for brachial plexus block performance, in terms of success rate, vascular punctures. The influence of obesity on performing time, total duration of the block, and success rate of brachial plexus block.Material and method: Prospective, randomized study which enrolled adult patients, scheduled for surgical emergency or elective surgical intervention on upper limb with brachial plexus block by axillary approach, using either the peripheral nerve stimulation or the ultrasound guidance.Results: We enrolled 160 patients, grouped in two sets- the ultrasound group= 82 patients (US) the neurostimulation group = 78 patients (NS). Vascular punctures were statistically significant different p= 0, 04. The success rate was not influenced by the obesity.Conclusions: Ultrasound guidance makes axillary brachial plexus block safer, we can recommend ultrasound guidance as routine for axillary brachial plexus block. The obese patient can beneficiate by both methods of brachial plexus blockage.

scholarly journals Peripheral Nerve Stimulator (PNS) Versus Trans-Arterial (TA) Techniques for Axillary Brachial Plexus Block

2021 ◽  
Vol 6 (1) ◽  
pp. 21-26
Author(s):  
Sunil Kumar Sah ◽  
Tofazzel Haque Sahana ◽  
Sekhar Ranjan Basu
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Success Rate ◽  
Brachial Plexus Block ◽  
Randomized Study ◽  
Nerve Stimulator ◽  
Peripheral Nerve Stimulator ◽  
Axillary Brachial Plexus Block ◽  
Significant Difference ◽  
Plexus Block

Background: Axillary brachial plexus block is one of the widely used techniques for upper extremity surgery. Peripheral nerve blocks (PNB) provide optimal surgical conditions while providing prolonged post-operative analgesia. The transarterial (TA) technique of axillary brachial plexus block is a well established method of producing regional anaesthesia for surgeries at or below elbow. In this prospective randomized study we compared, “peripheral nerve stimulator (PNS) versus trans-arterial (TA) techniques for axillary brachial plexus block” Methods: In this prospective, randomized study 80 patients, age>18 year, ASA-I & II, were divided randomly into two groups PNS and TA. In PNS groups 40 patients received axillary approach of brachial plexus block with the help of peripheral nerve stimulator, and rest TA group received axillary block through transarterial approach. Local anaesthetic 0.25% bupivacaine 15ml+1% lignocaine with adrenaline (1:200,000) 20 ml was used. Then success rate of two different methods of block were compared. Other parameters of comparison was block performance time of block, onset of sensory and motor block, failure rate, analgesia required etcetera. Results: The success rate of the block in PNS group was 90% and the success rate of TA group was 85% and there was no significant difference in success rate. Performance time was significantly low in trans-arterial axillary approach of brachial plexus block (p<0.005). There was no significant difference in onset of motor and sensory block. The sensory and motor functions returned properly in all patients. Conclusion: In our study we found that the PNS guided axillary block and TA injection axillary brachial plexus block provide similar success rate, and onset of block when musculocutaneous nerve blocked separately in the both techniques. Keywords: Axillary brachial plexus block, Trans-arterial approach, Peripheral nerve stimulator.

scholarly journals Different Learning Curves for Axillary Brachial Plexus Block: Ultrasound Guidance versus Nerve Stimulation

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
C. Luyet ◽  
G. Schüpfer ◽  
M. Wipfli ◽  
R. Greif ◽  
M. Luginbühl ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Nerve Stimulation ◽  
Ultrasound Guidance ◽  
Brachial Plexus Block ◽  
Learning Curves ◽  
Previous Experience ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block

Little is known about the learning of the skills needed to perform ultrasound- or nerve stimulator-guided peripheral nerve blocks. The aim of this study was to compare the learning curves of residents trained in ultrasound guidance versus residents trained in nerve stimulation for axillary brachial plexus block. Ten residents with no previous experience with using ultrasound received ultrasound training and another ten residents with no previous experience with using nerve stimulation received nerve stimulation training. The novices' learning curves were generated by retrospective data analysis out of our electronic anaesthesia database. Individual success rates were pooled, and the institutional learning curve was calculated using a bootstrapping technique in combination with a Monte Carlo simulation procedure. The skills required to perform successful ultrasound-guided axillary brachial plexus block can be learnt faster and lead to a higher final success rate compared to nerve stimulator-guided axillary brachial plexus block.

scholarly journals A Prospective, Randomized Comparison between Ultrasound and Nerve Stimulation Guidance for Multiple Injection Axillary Brachial Plexus Block

2007 ◽  
Vol 106 (5) ◽  
pp. 992-996 ◽  
Author(s):  
Andrea Casati ◽  
Giorgio Danelli ◽  
Marco Baciarello ◽  
Maurizio Corradi ◽  
Stefania Leone ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Nerve Stimulation ◽  
Ultrasound Guidance ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Patient Acceptance ◽  
Injection Technique ◽  
Multiple Injection ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block

Background This prospective, randomized, blinded study tested the hypothesis that ultrasound guidance can shorten the onset time of axillary brachial plexus block as compared with nerve stimulation guidance when using a multiple injection technique. Methods Sixty American Society of Anesthesiology physical status I-III patients receiving axillary brachial plexus block with 20 ml ropivacaine, 0.75%, using a multiple injection technique, were randomly allocated to receive either nerve stimulation (group NS, n = 30), or ultrasound guidance (group US, n = 30) for nerve location. A blinded observer recorded the onset of sensory and motor blocks, the need for general anesthesia (failed block) or greater than 100 microg fentanyl (insufficient block) to complete surgery, procedure-related pain, success rate, and patient satisfaction. Results The median (range) number of needle passes was 4 (3-8) in group US and 8 (5-13) in group NS (P = 0.002). The onset of sensory block was shorter in group US (14 +/- 6 min) than in group NS (18 +/- 6 min) (P = 0.01), whereas no differences were observed in onset of motor block (24 +/- 8 min in group US and 25 +/- 8 min in group NS; P = 0.33) and readiness to surgery (26 +/- 8 min in group US and 28 +/- 9 min in group NS; P = 0.48). No failed block was reported in either group. Insufficient block was observed in 1 patient (3%) of group US and 2 patients (6%) of group NS (P = 0.61). Procedure-related pain was reported in 6 patients (20%) of group US and 14 patients (48%) of group NS (P = 0.028); patient acceptance was similarly good in the two groups. Conclusion Multiple injection axillary block with ultrasound guidance provided similar success rates and comparable incidence of complication as compared with nerve stimulation guidance.

scholarly journals Comparison of ultrasound and electrical neurostimulation guidance in axillary brachial plexus block

2020 ◽  
pp. 50-53
Author(s):  
Omur Ozturk ◽  
Ali Bilge ◽  
Aysu Hayriye Tezcan ◽  
Hatice Yagmurdur ◽  
Gokhan Ragıp Ulusoy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Brachial Plexus ◽  
Motor Block ◽  
Ultrasound Guidance ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Axillary Brachial Plexus Block ◽  
Tunnel Syndrome ◽  
Plexus Block ◽  
Better Than

Objectives: To compare ultrasound guidance (USG) and electrical neurostimulation guidance (ENSG) in axillary brachial plexus block in terms of block performing time, sensory and motor block quality, and patient satisfaction. Methodology: 200 patients undergoing elective carpal tunnel syndrome surgery were randomly assigned to one of two groups; the USG group or the ENSG group. Axillary blocks were performed with a mixture of 15 ml of lidocaine 2% and 15 ml of bupivacaine 0.5% (a total of 30 ml solution). Sensory block was evaluated with a pinprick test and motor block was evaluated via the Bromage scale by a blinded observer. Results: Block performing time was significantly shorter in the USG group than in the ENSG group (P<0.001). The sensory and motor block onset times were significantly shorter and the additional analgesic requirements were significantly lower in the USG group than in the ENSG group (P<0.001). Conclusion: USG is better than ENSG in axillary brachial plexus block in terms of block performing time, block quality and patient satisfaction. Citation: Ozturk O, Bilge A, Tezcan AH, Tezcan HYAH, Ulusoy GR, Gezgin I, Dost B. Comparison of ultrasound and electrical neurostimulation guidance in axillary brachial plexus block. Anaesth Pain & Intensive Care 2016;20(1):50-53.

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