Effects of age on minimum effective volume of local anesthetic for ultrasound‐guided supraclavicular brachial plexus block

Šarić, Jadranka Pavičić; Vidjak, Vinko; Tomulić, Katarina; Zenko, Jelena

doi:10.1111/aas.12109

Cited by 51 publications

(5 citation statements)

References 26 publications

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“…The weak positive correlation between age and size of nerves may explain the reduced minimum effective volume for ultrasound-guided brachial plexus block in elderly patients. 13 Our results showed that the mean size of all nerves was bigger in males than females, although this result was only significant for the musculocutaneous, radial and ulnar nerves. The anaesthetic implications of this finding relate to the effectiveness of brachial blocks.…”

Section: Discussionmentioning

confidence: 49%

See 1 more Smart Citation

Relationship Between Gender, Age, BMI and Side of Body on the Size and Position of Nerves of the Brachial Plexus in Axilla: Pilot Study

Lalloo¹,

Gupta²

2021

LRA

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Section: Discussionmentioning

confidence: 49%

“…The weak positive correlation between age and size of nerves may explain the reduced minimum effective volume for ultrasound-guided brachial plexus block in elderly patients. 13 …”

Section: Discussionmentioning

confidence: 99%

Relationship Between Gender, Age, BMI and Side of Body on the Size and Position of Nerves of the Brachial Plexus in Axilla: Pilot Study

Lalloo¹,

Gupta²

2021

LRA

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“…In addition, most of the non-randomized trial studies have a low risk of bias in multiple domains, but there is an unclear risk in the rst domain for many of the included studies as elicited in Fig. As observed on Table 1, one of the studies was an observational study (39), three retrospective studies (24)(25)(26), four randomized control trials (27)(28)(29)(30), and 10 prospective studies (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Among the included studies, the sample sizes vary signi cantly, ranging from relatively small cohorts of 20 patients Xavier P et al, 2002 (31) to large-scale investigations such as the study by Ottokar et al, 2014 (24), which encompassed an extensive cohort of 17,157 individuals.…”

Section: Resultsmentioning

confidence: 99%

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

Yin,

Wally,

OLAGUNJU

et al. 2024

Preprint

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Background The geriatric population presents unique challenges in the perioperative setting due to age-related physiological changes, comorbidities, and altered drug responses. Adapting anesthesia to the particular requirements of elderly patients is crucial for maximizing the success of surgical procedures and reducing the risk of complications and death during the perioperative period; this systematic review aims to assess the selection of anesthetic methods and medications used in upper limb surgeries for elderly patients. By compiling and analyzing data from existing published research, the review seeks to clarify the relative effectiveness, safety, and potential outcomes of various anesthesia techniques used in older individuals undergoing surgeries on the upper extremities. Methods Our study employed a systematic review methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study evaluated anesthesia techniques and drugs for upper limb surgery in older adults. Articles were identified through WEB of SCIENCE, MEDLINE, PUBMED, CINAHL searches, and Hand-Searching from January 2000 to January 2024, with eligibility criteria targeting studies on anesthesia for upper extremity surgeries only in older adults ≥ 65 years. Data extraction included study characteristics and outcomes related to anesthesia techniques and drugs. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for non-randomized studies of interventions. Results 18 articles met the inclusion criteria for the systematic review. The effectiveness of regional anesthesia is influenced by several factors. The addition of upper-extremity peripheral nerve blocks to general anesthesia during total shoulder arthroplasty has been shown not to increase the risk of complications or resource utilization. In arteriovenous fistula surgery, the application of a brachial plexus block for anesthesia has been shown to increase tissue oxygenation, as indicated by Near-Infrared Spectroscopy. Rotator cuff surgery pain management now favors continuous supraclavicular block, offering comparable pain relief to interscalene block but with fewer side effects Conclusion The review emphasizes the significance of selecting appropriate anesthesia techniques and drugs for upper limb surgery in elderly patients to enhance surgical outcomes and reduce perioperative complications.

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“…One prospective double-blind study reported an almost 50% decrease in minimum effective local anesthetic volume required for brachial plexus block in patients older than 65 years. [ 12 ] These patients also have smaller cross-sectional areas of the brachial plexus compared with younger patients. [ 12 ] Similar findings were shown following epidural analgesia, in which patients >70 years used lower median effective concentrations (EC50) of ropivacaine to attain complete motor blockade in the perineum or lower limbs.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 ] These patients also have smaller cross-sectional areas of the brachial plexus compared with younger patients. [ 12 ] Similar findings were shown following epidural analgesia, in which patients >70 years used lower median effective concentrations (EC50) of ropivacaine to attain complete motor blockade in the perineum or lower limbs. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient

et al. 2015

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Background:The elderly represent a unique challenge for the effects of regional anesthesia, and very few cases of block onset delay have been described. Their delayed response is attributed to a number of factors that include: Physiologic deterioration, musculoskeletal contractures, degenerative joint disease, autonomic regulatory dysfunction, cognitive dysfunction, altered pharmacokinetics, and pharmacodynamics of local anesthetics and adjuvants.Case Description:In this report we present the rare case of 45-min delay between the administration and onset of action of a subarachnoid blockade in a 103-year-old female, who was scheduled for left hip pinning, for repair of a femoral neck fracture. Patient received an injection of hyperbaric bupivacaine, 1.5 ml of 0.75% (11.25 mg), with 15 mcg of fentanyl into the subarachnoidal space and underwent the surgical procedure without complications.Conclusions:Delayed responses to subarachnoid anesthesia can be expected in extremely elderly patients. Anesthetic procedures should be monitored and managed on a case-by-case basis.

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Effects of age on minimum effective volume of local anesthetic for ultrasound‐guided supraclavicular brachial plexus block

Abstract: Within the present study, we report a reduced minimum effective anesthetic volume for ultrasound-guided supraclavicular block in elderly patients. Additionally, smaller cross-sectional surface area of brachial plexus in the supraclavicular region was observed.

Cited by 51 publications

References 26 publications

Relationship Between Gender, Age, BMI and Side of Body on the Size and Position of Nerves of the Brachial Plexus in Axilla: Pilot Study

Relationship Between Gender, Age, BMI and Side of Body on the Size and Position of Nerves of the Brachial Plexus in Axilla: Pilot Study

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient

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