Comparison of two neurostimulation techniques for axillary brachial plexus blockade

Abstract

This prospective, randomized, double-blind study compared two techniques of axillary brachial plexus block using a peripheral nerve stimulator. Both groups received initial musculocutaneous nerve block followed by either a single injection on median nerve stimulation (group 1) or a double injection divided between median and radial nerves (group 2). All 60 patients received a total of 30 ml of lidocaine 15 mg/ml with epinephrine 5 microg/ml. Complete sensory blockade of all six peripheral nerves occurred in 53% and 97% of patients in groups 1 and 2, respectively (P<0.001), with a more rapid onset of blockade occurring in group 2 patients (P<0.001). Complete motor blockade was evident in 30% and 83% of patients in groups 1 and 2, respectively (P<0.001).

Ultrasound guidance and success rates of axillary brachial plexus block - II

“…[3][4][5] The authors reported a success rate of 62.9% for median, ulnar and radial sensory block, which is relatively low compared with currently published data (> 92% success rates) and our clinical experience. 6 Despite this discrepancy, the authors conclude that ultrasound "significantly improves the success rate."…”

“…Coventry et al 3 performed triple stimulation axillary block (25 mL lidocaine 1.5% with epinephrine), reporting 100% sensory blockade of median, ulnar and radial nerves to pinprick at 30 min. Sia et al 4 performed triple stimulation axillary block (36 mL lidocaine 2% and bupivacaine 0.5%).…”

Unilateral Horner&apos;s Syndrome following supraclavicular brachial plexus block

“…[3][4][5] In particular, the brachial plexus block has many advantages in the surgery of the upper extremity due to various advantages of local anesthesia. 6 Theoretically, if a local anesthetic is injected into the neurovascular sheath surrounding the brachial plexus, its distribution may block the nerves of the brachial plexus but the actual effects may vary. [7][8][9] Horner's Syndrome may occur even with the interception of the sympathetic nervous pathway from the hypothalamus to the eyeball.…”

Comparison of Nerve Stimulator and Ultrasonography Application for Brachial Plexus Anesthesia

“…A more effective second method is the multiple approach to terminal nerve branches by using nerve stimulation (11,12). Nerve stimulators, that were first applied in 1912 but only put into clinical use in 1962, have been an alternative to the technique of paraesthesia.…”