180Selective radial or ulnar nerve localization in triple-injection technique of axillary brachial plexus block: success of sensor and motor block

2006 ◽  
Vol 31 (5) ◽  
pp. 22-22
Author(s):  
D BARTOLEK ◽  
S BARANOVIC ◽  
K SAKICZDRAVCEVIC
Keyword(s):  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Injection Technique ◽  
Axillary Brachial Plexus Block ◽  
Block Success ◽  
Plexus Block ◽  
Nerve Localization

scholarly journals Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Suresh Kumar Vallapureddy ◽  
Gajanan Fultambkar ◽  
V. Rajeswar Rao ◽  
Vinay Kukreja ◽  
Rammohan Gurram ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Local Anesthetic ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Demographic Data ◽  
Controlled Study ◽  
Injection Technique ◽  
Double Injection ◽  
Performance Time ◽  
Plexus Block

<b><i>Background:</i></b> The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. <b><i>Methods:</i></b> After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. <b><i>Results:</i></b> The demographic data were comparable between both groups. The DI group had a significantly faster onset than the SI group (<i>p</i> = 0.0172). There was a statistically significant lesser performance time in group SI than in group DI (<i>p</i> &#x3c; 0.034). The sensory and motor block achieved was comparable between both groups. <b><i>Conclusion:</i></b> The success rates in both the SI and DI techniques are comparable. The DI technique results in a faster onset and hence a shorter TART; however, it may not be clinically relevant.

scholarly journals Effects of Clonidine as an Adjuvant to Lidocaine with Epinephrine in Ultrasound Guided Axillary Brachial Plexus Block: A Randomised Controlled Trial

2021 ◽  
Vol 10 (18) ◽  
pp. 4181
Author(s):  
Anil Ranganath ◽  
Tomas Hitka ◽  
Gabriella Iohom
Keyword(s):  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Ultrasound Guided ◽  
Axillary Brachial Plexus Block ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

This study evaluated the effects of adding adjuvant clonidine to lidocaine with epinephrine on the characteristics of ultrasound-guided axillary brachial plexus block (ABPB) for upper extremity surgery. Twenty-four patients were randomised to receive an ultrasound guided ABPB with 20 mL of lidocaine 2% with 1:200,000 epinephrine plus 2 mL of either normal saline 0.9% (Group 1) or a mixture of clonidine 1 µg/kg and normal saline 0.9% (Group 2). The outcome measures that were recorded were the overall onset time and the duration of sensory and motor block. The median (IQR) overall onset time of sensory and motor block was significantly shorter in Group 2 vs. Group 1 (5 (5–7.5) min vs. 10 (8.8–12.5) min; p < 0.001) and (5 (2.5–7.5) min vs. 7.5 (6.3–7.5) min; p = 0.001), respectively. The median (IQR) overall duration of sensory and motor block was significantly longer in Group 2 vs. Group 1 (225 (200–231) min vs. 168 (148–190) min; p < 0.001) and (225 (208–231) min vs. 168(148–186) min; p < 0.001), respectively. In ultrasound-guided ABPB, the addition of clonidine to lidocaine with epinephrine resulted in shorter onset time and prolonged duration of sensory and motor block.

scholarly journals An Estimation of the Minimum Effective Anesthetic Volume of 2% Lidocaine in Ultrasound-guided Axillary Brachial Plexus Block

2009 ◽  
Vol 111 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Brian D. O’Donnell ◽  
Gabrielle Iohom
Keyword(s):  
Brachial Plexus ◽  
Local Anesthetic ◽  
Brachial Plexus Block ◽  
Hand Surgery ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Performance Time ◽  
Axillary Brachial Plexus Block ◽  
Block Success ◽  
Plexus Block

Background Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block. Methods After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve. Results The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases. Conclusion Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.

The Study of Effectiveness of Ropivacaine in Axillary Brachial Plexus Block for Forearm Surgery

2020 ◽  
Vol 22 (4) ◽  
pp. 248-253
Author(s):  
Sulav Acharya ◽  
GR Bajracharya ◽  
S Gauchan ◽  
N Dhakal
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Analgesic Effect ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Sensory Block ◽  
Axillary Brachial Plexus Block ◽  
The Mean ◽  
Plexus Block

Brachial plexus block is a suitable alternative to general anaesthesia for patient undergoing upper extremity surgery. Ropivacaine the S-enantiomer emerged as a possible replacement of Bupivacaine without undesirable toxic effects.Therefore this study was conducted to assess the block characteristics and side effects of 0.75% ropivacaine in axillary brachial plexus block for forearm surgeries. This interventional study was carried out in 30 patients of ASA physical status I or II, aged 18 to 60 yrs undergoing elective surgery u nder axillary brachial plexus block with 20 ml of 0.75 % Ropivacaine using ultrasound and nerve stimulator. The mean onset time of sensory block was 4.53 ± 1.18 minutes and duration of sensory block was 491.00 ± 57.45 minutes. The mean onset time of motor block was 9.17 ± 1.39 minutes and duration of motor block was 452.50 ± 52.34 minutes. The mean time for rescue analgesia or total analgesic effect was 569.47 ± 88.46 minutes. No patients developed any side effects. The result of this study concluded that Ropivacaine is a safe drug providing longer duration of sensory analgesic effect and early recovery of motor function with good operating conditions for forearm surgeries under brachial blexus block.

scholarly journals Comparison Between the Two-Injection Technique and the Four-Injection Technique in Axillary Brachial Plexus Block with Articaine

2017 ◽  
Vol 45 (5) ◽  
pp. 289-296
Author(s):  
Aysun Ertikin ◽  
Guldeniz Argun ◽  
Mesut Misirlioglu ◽  
Murat Aydin ◽  
Murat Arikan ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Injection Technique ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block
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