scholarly journals Comparative Anesthesia Effect of Brachial Plexus Block Based on Smart Electronic Medical Ultrasound-Guided Positioning and Traditional Anatomical Positioning

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Zhaoxiang Yu ◽  
Yang Liu ◽  
Chunlei Zhu
Keyword(s):  
Arterial Pressure ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Hand Surgery ◽  
Anatomical Variations ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Visualization Technology ◽  
Plexus Block ◽  
Time Point

With the intensification of population aging, the improvement of visualization technology, and the concept of accelerated rehabilitation surgery, the anesthesia method of upper extremity surgery is gradually changing. However, these methods are often caused by anatomical variations and often have low block success rates and patient satisfaction. The neuroanatomical position should be accurately located so that the puncture needle is right next to the nerve bundle or in the nerve sheath. This is very important for implementing accurate brachial plexus anesthesia. This article uses ultrasound-guided positioning technology and traditional anatomical positioning technology for brachial plexus block treatment, aiming to explore the anesthesia effect of brachial plexus block with different techniques. This article selects 120 patients undergoing brachial plexus block surgery for forearm or hand surgery and divides these 120 patients into 6 groups with 20 people in each group. The first 3 groups were treated with brachial plexus block using ultrasound-guided positioning technology. The latter 3 groups were treated with brachial plexus block using traditional anatomical positioning technology. Experiments proved that during anesthesia, compared with the ultrasound group, the heart rate of the traditional anatomy group was significantly decreased ( P < 0.05 ), and the average arterial pressure of the six groups of patients at each time point had no statistical difference ( P > 0.05 ). This shows that whether it is ultrasound-guided positioning technology or traditional anatomical positioning technology, it has no effect on the average arterial pressure of the patient at each time point. In addition to intuitive and accurate viewing of needle and nerve contact, ultrasound real-time guidance allows intuitive viewing of anesthesia. This is a special advantage of nerve block under ultrasound guidance.

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.

scholarly journals Ultrasound Guided Axillary Brachial Plexus Block Versus Supraclavicular Block In Emergency Crushed Hand Patients : A Comparative Study

2018 ◽  
Vol 12 (1) ◽  
pp. 34-41
Author(s):  
Rania Maher Hussien ◽  
Dalia Ahmed Ibrahim
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Hand Surgery ◽  
Good Alternative ◽  
Ultrasound Guided ◽  
Performance Time ◽  
Needle Pass ◽  
Supraclavicular Block ◽  
Plexus Block

Background: The current study focusses on ultrasound guided Brachial Plexus Block (BPB) which plays an important role in patients with hand trauma either in pain control or for surgical intervention. The brachial plexus can be blocked by several techniques but the most commonly used are the Supraclavicular (SCB) and Axillary (AXB) blocks. Objective: To compare the two techniques with regards to the performance time, needling time, anesthesia-related time, block-related complications, number of needle pass and block related pain. Methods: After approval of the ethical committee and obtaining a written informed consent from patients, this prospective, randomized, interventional double-blinded study was done to patients undergoing emergency crushed hand surgery. 80 patients were allocated randomly into two equal groups. Under ultrasound guidance, the SCB and AXB were done for the two groups, respectively. The needling time, performance time, anesthesia-related time, onset time, number of 1st needle pass in each group and block related complications were noted. Statistical Analysis: Data were analysed using the Statistical Package for Social Science (IBM SPSS) version 23 SPSS. Results: Longer needling, performance, anesthesia-related time in the AXB group than SCB and less complications have occurred with AXB than SCB group. Conclusion: Axillary block of brachial plexus is a good alternative to Supraclavicular block in emergency crushed hand surgery and the choice is made according to the requirement of each case.

scholarly journals A Triple-Masked, Randomized Controlled Trial Comparing Ultrasound-Guided Brachial Plexus and Distal Peripheral Nerve Block Anesthesia for Outpatient Hand Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Nicholas C. K. Lam ◽  
Matthew Charles ◽  
Deana Mercer ◽  
Codruta Soneru ◽  
Jennifer Dillow ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Motor Function ◽  
Brachial Plexus Block ◽  
Controlled Trial ◽  
Hand Surgery ◽  
Strength Loss ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Plexus Block

Background. For hand surgery, brachial plexus blocks provide effective anesthesia but produce undesirable numbness. We hypothesized that distal peripheral nerve blocks will better preserve motor function while providing effective anesthesia.Methods. Adult subjects who were scheduled for elective ambulatory hand surgery under regional anesthesia and sedation were recruited and randomly assigned to receive ultrasound-guided supraclavicular brachial plexus block or distal block of the ulnar and median nerves. Each subject received 15 mL of 1.5% mepivacaine at the assigned location with 15 mL of normal saline injected in the alternate block location. The primary outcome (change in baseline grip strength measured by a hydraulic dynamometer) was tested before the block and prior to discharge. Subject satisfaction data were collected the day after surgery.Results. Fourteen subjects were enrolled. Median (interquartile range [IQR]) strength loss in the distal group was 21.4% (14.3, 47.8%), while all subjects in the supraclavicular group lost 100% of their preoperative strength,P= 0.001. Subjects in the distal group reported greater satisfaction with their block procedures on the day after surgery,P= 0.012.Conclusion. Distal nerve blocks better preserve motor function without negatively affecting quality of anesthesia, leading to increased patient satisfaction, when compared to brachial plexus block.

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