A Prospective, Randomized, Double-Blind Comparison of Ultrasound-Guided Axillary Brachial Plexus Blocks Using 2 Versus 4 Injections

Imasogie, Ngozi; Ganapathy, Sugantha; Singh, Sudha; Armstrong, Kevin; Armstrong, Paidrig

doi:10.1213/ane.0b013e3181cb6791

Cited by 57 publications

(55 citation statements)

References 4 publications

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“…supraclavicular [7,26,28,33,36,37,41]; and one trial compared the three approaches [6]. Eleven trials compared one with multiple injections: for the axillary approach [22,23,30,34,40]; for the infraclavicular approach [27,29,32]; and for the supraclavicular approach [9][10][11]. Five authors provided data when requested [7,10,26,27,32].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of ultrasound‐guided methods for brachial plexus blockade

et al. 2015

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SummaryWe systematically reviewed 25 randomised controlled trials of ultrasound-guided brachial plexus blockade that recruited 1948 participants: either one approach vs another (axillary, infraclavicular or supraclavicular); or one injection vs multiple injections. There were no differences in the rates of successful blockade with approach, relative risk (95% CI): axillary vs infraclavicular, 1.0 (1.0-1.1), p = 0.97; axillary vs supraclavicular, 1.0 (1.0-1.1), p = 0.68; and infraclavicular vs supraclavicular, 1.0 (1.0-1.1), p = 0.32. There was no difference in the rate of successful blockade with the number of injections, relative risk (95% CI) 1.0 (1.0-1.0), p = 0.69, for one vs multiple injections. The rate of procedural paraesthesia was less with one injection than multiple injections, relative risk (95% CI) 0.6 (0.4-0.9), p = 0.004.

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Section: Resultsmentioning

confidence: 99%

A systematic review of ultrasound‐guided methods for brachial plexus blockade

et al. 2015

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“…Two recent studies have shown that two injections (one around the musculocutaneous nerve and another posterior to the axillary artery) provide an equivalent success rate than the identification and injection of each of the four major nerves. 30,31 In addition to reducing the time needed to perform the block, this technique requires the operator to identify only the musculocutaneous nerve, which greatly simplifies the technique (Fig. 9) (Videos 4a and 4b, available as ESM).…”

Section: Axillary Approachmentioning

confidence: 99%

“…Deux études récentes ont démontré que deux injections (une autour du nerf musculocutané et une seconde en postérieur de l'artère axillaire) procurent un aussi bon taux de succès que l'identification et l'injection de chacun des quatre nerfs majeurs. 30,31 En plus de réduire la durée de réalisation du bloc, cette technique nécessite uniquement l'identification du nerf musculocutané, simplifiant grandement la technique (Fig. 9), (Vidéos 4a et 4b, disponibles en matériel électronique supplémentaire).…”

Section: Approche Infraclaviculaireunclassified

Ultrasound-guided regional anesthesia for upper limb surgery

Nadeau

Lévesque

Dion

2013

Can J Anesth/J Can Anesth

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“…The mean time required for these manipulations and the deposition of an anaesthetic agent during ultrasound-guided axillary block ranges from app. eight minutes to more than 15 minutes (Table 3) [6,8,20,21]. In this case, the time required for preparation, setup of the ultrasound machine and protection of a transducer.…”

Section: Time Of Block and Onset And Duration Of Analgesiamentioning

confidence: 99%

Blokada pachowa splotu ramiennego pod kontrolą ultrasonografii. Część 2 — techniki wykonania

Nowakowski¹,

Bieryło²

2015

Anaesthesiol Intensive Ther

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Axillary brachial plexus block is one of the most frequently employed peripheral blocks. The popularity of axillary block stems from its success as a safe and relatively easy technique with numerous applications. The technique of axillary block has evolved. It was modified after the development of precise nerve localization modalities. Currently, ultrasound is the most important localization technique for regional anaesthesia. Ultrasound-guided axillary block encompasses a spectrum of techniques. The selection of a specific technique can be adjusted to an operator's individual level of skill and proficiency. Axillary block under US-guidance can be performed using a traditional perivascular method and by placing a selective blockade of individual nerves that supply the surgical area. Regardless of the selected method, it enables the incorporation of individual patient anatomical variation in an anaesthesia plan. This paper discusses the technical details and efficacy issues of US-guided axillary brachial plexus block techniques.Keywords: regional anaesthesia, peripheral nerve block, brachial plexus; regional anaesthesia, peripheral nerve block, axillary block; regional anaesthesia, techniques Anaesthesiology Intensive Therapy 2015, vol. 47, no 4, 417-424 Axillary brachial plexus block is one of the most frequently employed peripheral blocks. The popularity of axillary block derives from its success as a very safe and relatively easy technique with numerous applications. The technique of axillary block has evolved. It was modified after the development of precise nerve localization modalities. Currently, ultrasonography is the most important localization technique for regional anaesthesia. Ultrasound-guided axillary block encompasses a spectrum of techniques. The selection of a specific technique can be adjusted to an operator's individual skills and proficiency. Ultrasound-guided axillary block can be performed using a traditional perivascular method and by placing a selective blockade of individual brachial plexus branches that supply the field of surgical operation. Regardless of the selected method, it enables the incorporation of individual anatomical variability into the anaesthesia plan of a patient. TECHNIQUE OF ULTRASOUND-GUIDED AXILLARY BRACHIAL PLEXUS BLOCKThe use of ultrasonography enables all steps of a regional block to be controlled, such as determination of the anatomical structure of the anaesthetized region via realtime control, operational correction of the needle position and verification of the injection site and pathway of local anaesthetic agent dispersion [2]. Ultrasonography enables the assignment of an optimal site of needle puncture and the planning of the insertion vector based on the topographic relationships among particular patients.The utilization of this technique has introduced new possibilities of axillary block performance and has significantly changed its operation compared with traditional methods. Assuming that a crucial factor of effective/failed block is the appr...

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A Prospective, Randomized, Double-Blind Comparison of Ultrasound-Guided Axillary Brachial Plexus Blocks Using 2 Versus 4 Injections

Abstract: An ultrasound-guided 2-injection axillary block may be as effective as, and more time efficient than, a 4-injection technique.

Cited by 57 publications

References 4 publications

A systematic review of ultrasound‐guided methods for brachial plexus blockade

A systematic review of ultrasound‐guided methods for brachial plexus blockade

Ultrasound-guided regional anesthesia for upper limb surgery

Blokada pachowa splotu ramiennego pod kontrolą ultrasonografii. Część 2 — techniki wykonania

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