83. Erfahrungen bei Blockaden des Plexus brachialis

Abstract

Experiences and results of 7212 brachial plexus blocks by the supraclavicular and 404 by the axillary approach are reported. The times of onset and duration of several local anesthetics are compared. The incidence of pneumothorax was 0.42% (30 cases) when the supraclavicular approach was used. Therefore the axillary technique is recommended to avoid this serious complication.

Incidence of clinically symptomatic pneumothorax in ultrasound‐guided infraclavicular and supraclavicular brachial plexus block

“…As the method became more widespread in the middle of the 20th century, the pneumothorax rate in a large case series was reported as 0.2–6.1% for SCB without ultrasound guidance . If we only consider those studies with ≥ 500 blocks, the rate is 0.4% (95% CI 0.29–0.46) for the 20 340 blocks that were performed . The much higher incidence of 6.1% (95% CI 3–9.2), which is often cited, stems from a study of 230 SCB; in this series, the majority of the blocks were performed by anaesthesiology residents in the first or second year of their training with prior experience of fewer than 10 blocks .…”

“…Very soon after the initial description of SCB , reports appeared about the occurrence of pneumothorax associated with the blocks, which resulted in the deaths of three patients . As the method became more widespread in the middle of the 20th century, the pneumothorax rate in a large case series was reported as 0.2–6.1% for SCB without ultrasound guidance . If we only consider those studies with ≥ 500 blocks, the rate is 0.4% (95% CI 0.29–0.46) for the 20 340 blocks that were performed .…”