A Comparison of Three Methods of Axillary Approach to Brachial Plexus Blockade for Upper Extremity Surgery

Goldberg, Michael E.; Gregg, Charles; Larijani, Ghassem E.; Norris, Mark C.; Marr, Alexander T.; Seltzer, Joseph L.

doi:10.1097/00000542-198706000-00017

Cited by 107 publications

(36 citation statements)

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“…Transarterial access is achieved with double injection, being one superficial and the other deep to the axillary artery. Success rate of 83.3% in our study was close to that observed in some studies (79% 19 , 88.8% 20 ), however lower than 92% 16 and 95% 1 of other studies. Success rate of 92.5% obtained with multiple stimulations is similar to results obtained by other studies, which have varied from 88% to 93% 4,5,8 .…”

Section: Discussionsupporting

confidence: 87%

“…O acesso transarterial é realizado com dupla injeção, sendo uma superficial e outra profunda à artéria axilar. O índice de sucesso de 83,3% neste estudo, ficou próximo ao observado em alguns trabalhos (79% 19 21,22 , a técnica da injeção transarterial é considerada segura, o que demonstra uma análise prospectiva de 1000 pacientes 20 . Neste estudo, o acompanhamento por 48 horas no pós-operatório não evidenciou qualquer complicação.…”

Section: Discussionunclassified

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Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina

Imbelloni¹,

Beato²,

Cordeiro³

2005

Rev. Bras. Anestesiol.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionunclassified

Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina

Imbelloni¹,

Beato²,

Cordeiro³

2005

Rev. Bras. Anestesiol.

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“…The AXBs were performed either under US-guidance 7 or using TRAD, specifically, multiple injection PNS 11 or the transarterial (TA) 12 technique. Peripheral nerve stimulation-guided AXB was performed using a nerve stimulator (Stimuplex®, B. Braun Medical, Bethlehem, PA, USA) with a stimulating frequency of 2 Hz, and a pulse width of 100 µsec.…”

Section: Methodsmentioning

confidence: 99%

Evolution of ultrasound guided axillary brachial plexus blockade: retrospective analysis of 662 blocks

Brull

Perlas

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: Ultrasound (US) is being used increasingly to guide needle placement during axillary brachial plexus blockade (AXB). This retrospective study investigated whether US guidance can increase the success rate, decrease block onset time, and reduce local anesthetic (LA) volume for AXB compared to a traditional (TRAD) approach, namely, peripheral nerve stimulation (PNS) and transarterial (TA) techniques. Methods:The anesthetic records, operative reports, discharge summaries, and surgical consultation notes of all patients who had undergone AXB for surgical anesthesia at the Toronto Western Hospital, between October 2003 and November 2006 were, retrospectively reviewed for evidence of block success and associated complications. Block success was defined as the achievement of surgical anesthesia without additional LA supplementation.Results: Among the 662 patients, 535 patients underwent AXB using US guidance (US group), and 127 using TRAD techniques (TRAD group), namely, 56 using PNS (PNS subgroup) and 71 using the TA technique (TA subgroup). The block success rate was higher in the US group compared to the TRAD group (91.6% vs 81.9%, p = 0.003). The LA volume used for AXB was less in the US group compared to the TRAD group (39.8 ± 6.4 mL vs 46.7 ± 17.1 mL, p < 0.0001). Ultrasound group patients spent less time in the block procedure room than those in the TRAD group (30.6 ± 14.2 min vs 40.1 ± 27.3 min, p < 0.0001). When analyzed by subgroup, the US group demonstrated significantly greater success and shorter duration in the block room compared to the PNS subgroup, but not the TA subgroup. Complications (inadvertent intravenous LA injection, and transient neuropathy) were lower in the US group compared to the TRAD group (0.37% vs 3.15%, p = 0.014). Conclusions:Our results suggest that US-guided AXB may improve block success, reduce the local anesthetic volume used, and shorten the time spent in the block room compared to traditional nerve localization techniques.

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“…In a study by Goldberg et al, 22 the techniques of transarterial fixation, paraesthesia and nerve stimulation were compared and shown to have similar success rates. However, only single doses of anaesthesia were used, whereas multiple injections may have been more suitable.…”

Section: Discussionmentioning

confidence: 99%

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

et al. 2014

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Objective: The effectiveness of axillary brachial plexus block (ABPB) performed using peripheral nerve stimulation (PNS) alone was compared with PNS preceded by nerve localization using a pen device, enabling nerve mapping without puncturing the skin. Methods: Patients undergoing unilateral hand or forearm surgery suitable for ABPB were randomly assigned to receive either PNS alone (pen À group) or PNS preceded by nerve localization using a pen device (pen þ group). Parameters related to the block procedure and patient comfort were assessed. Results: Thirty patients were included in each group. The block performance time was longer in the pen þ group than the pen À group despite a reduced number of needle insertions. The complete block rate was higher and intraoperative analgesic usage lower in the pen þ group compared with the pen À group. Patient satisfaction and complication rates were similar in the two groups. Conclusion: The pen device seems to be a helpful addition to PNS for ABPB, with improved results in terms of block success and patient comfort, but further studies are needed to confirm these findings.

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A Comparison of Three Methods of Axillary Approach to Brachial Plexus Blockade for Upper Extremity Surgery

Cited by 107 publications

References 0 publications

Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina

Comparação das técnicas transarterial e de estimulação de múltiplos nervos para bloqueio do plexo braquial por via axilar usando lidocaína com epinefrina

Evolution of ultrasound guided axillary brachial plexus blockade: retrospective analysis of 662 blocks

Effect of nerve localization using a pen device on the success of axillary brachial plexus block

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