Increased success rate with infraclavicular brachial plexus block using a dual-injection technique

Rodríguez, Jaime; Bárcena, María; Lagunilla, J; Álvarez, J.

doi:10.1016/j.jclinane.2003.08.006

Cited by 29 publications

(16 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13 Anatomic considerations may explain our results. We believe that ILVA is a different approach of the brachial plexus of nerves than that proposed by Gaertner et al 13 and Rodriguez et al 9,16,17 Indeed, both authors used a coracoid approach of the brachial plexus of nerves, but they certainly reached neural structures in the coracoid space situated below the superior edge of pectoralis minor muscle. Conversely, we placed ILVA combining both a supracoracoid lateral puncture and a vertical direction of needle.…”

Section: Discussionmentioning

confidence: 83%

Single-Stimulation, Low-Volume Infraclavicular Plexus Block: Influence of the Evoked Distal Motor Response on Success Rate

Bloc¹,

Garnier²,

Komly³

et al. 2006

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 83%

Single-Stimulation, Low-Volume Infraclavicular Plexus Block: Influence of the Evoked Distal Motor Response on Success Rate

Bloc¹,

Garnier²,

Komly³

et al. 2006

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

“…We hypothesized that ultrasound guidance increases the success rate of infraclavicular block from 68% [1][2][3][4][5][6] to 90% compared with a dual endpoint stimulation technique. Assuming a = 0.05 and b = 0.2 required a sample size of 106 patients (53 per group).…”

Section: Discussionmentioning

confidence: 99%

“…While various nerve stimulator-guided approaches to infraclavicular block have been described in the literature, [1][2][3][4][5][6] success rates reportedly range from only 60 to 79%. The highest success rate is associated with multiple-cord stimulation, 3,5,6 such that the elicitation of motor twitches corresponding to at least two cords (i.e., dual motor endpoint) is the most reliable goal for traditional nerve stimulator-guided infraclavicular block. Early reports suggest that ultrasound may be associated with faster onset, greater success, and fewer adverse effects compared with some traditional stimulation-guided approaches for infraclavicular block.…”

Section: Résumémentioning

confidence: 99%

Compared with dual nerve stimulation, ultrasound guidance shortens the time for infraclavicular block performance

Brull

Lupu

Perlas

et al. 2009

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose The success rate for infraclavicular brachial plexus block using nerve stimulation reportedly ranges from 60 to 80%. Ultrasound guidance may be associated with greater success. This study compared ultrasound guided infraclavicular block with a dual motor endpoint nerve stimulation technique. Methods One hundred three hand surgery patients were randomized to receive either ultrasound-guided (ultrasound group) or dual motor endpoint nerve stimulation (stimulation group) infraclavicular block using 2% lidocaine 15 mL and 0.5% bupivacaine 15 mL with epinephrine. Block success was defined as loss of sensation to pinprick in each of the radial, ulnar, median, and musculocutaneous nerve distributions when measured 20 min after block performance. Block performance time, readiness for surgery (no supplemental block, skin infiltration, or general anesthesia), and complications were also assessed.Results Patient characteristics were similar between groups. Success rate was 92% in the ultrasound group and 80% in the stimulation group (P = 0.18). Block performance time was shorter in the ultrasound group (median 5 min) compared with the stimulation group (median 10.5 min) (P \ 0.001). Paresthesiae were more frequent in the stimulation group (45%) than in the ultrasound group (6%) (P \ 0.001). After final injection, more patients were ready for surgery in the ultrasound group (85%) than in the stimulation group (65%) (P = 0.04). At 1 week postoperatively, complications were minor and transient and did not differ between groups. Conclusion There was no statistically significant difference in the success rate between ultrasound guidance and dual motor endpoint stimulation for infraclavicular block. However, ultrasound guidance shortens performance time and improves readiness for surgery compared with dual motor endpoint stimulation (Clinical Trial Registration Number: NCT00326261). RésuméObjectif Selon la litte´rature, le taux de re´ussite d'un bloc infraclaviculaire du plexus brachial re´alise´par stimulation nerveuse se situe entre 60 % et 80 %. L'e´choguidage pourrait eˆtre associe´a`un taux de re´ussite plus e´leve´. Cette e´tude a compare´un bloc infraclaviculaire re´alise´par e´choguidage a`une technique de double stimulation nerveuse des extre´mite´s motrices. Méthode Cent-trois patients devant subir une chirurgie de la main ont e´te´randomise´s à recevoir un bloc infraclaviculaire re´alise´soit par e´choguidage (groupe e´choguidage) ou par double stimulation nerveuse des extre´mite´s motrices (groupe stimulation) a`l'aide de 15 mL de lidocaı¨ne 2 % et de 15 mL de bupivacaı¨ne 0,5 % avec e´pine´phrine. La re´ussite du bloc a e´te´de´finie en tant que la

show abstract

“…With few exceptions, 29,45 anesthesiologist-related indicators of success, such as sensory block, motor block, block procedure time, block onset time, readiness for surgery, supplemental inject ion, unplanned GA, block duration, and block-related complications were assessed. Partial or complete sensory block was reported in every trial.…”

Section: Anesthesiologist Relatedmentioning

confidence: 99%

The Definition of Block “Success” in the Contemporary Literature

Abdallah

Brull

2012

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

A successful nerve block is the common goal that shapes modern regional anesthesia practice and research, yet the meaning of block "success" can be open to interpretation. For this Special Article, we reviewed all applicable randomized controlled trials published over the last decade to determine the most commonly used definitions of block success. We also sought to uncover which relevant indicators of block success are routinely reported in the contemporary literature. Twenty-two trials that explicitly designated the term block "success" as their primary outcome measure were identified. The most common definition of block success was the achievement of a surgical block within a designated period, used in half of the trials. Block success was inconsistently defined in the remaining 11 trials. Patient-related indicators of block success including postoperative pain and patient satisfaction were measured in only 4 trials, whereas anesthesiologist-related indicators such as block onset time and complications were reported most frequently. Surgeon- and hospital administrator-related indicators were not collected in any trial. We found that the definition of block success is highly variable in the contemporary regional anesthesia literature. Our findings underscore the clear and present need for a comprehensive definition of block success, whereas future research should endeavor to capture the indicators of block success that are important to all key perioperative stakeholders.

show abstract

Increased success rate with infraclavicular brachial plexus block using a dual-injection technique

Cited by 29 publications

References 26 publications

Single-Stimulation, Low-Volume Infraclavicular Plexus Block: Influence of the Evoked Distal Motor Response on Success Rate

Single-Stimulation, Low-Volume Infraclavicular Plexus Block: Influence of the Evoked Distal Motor Response on Success Rate

Compared with dual nerve stimulation, ultrasound guidance shortens the time for infraclavicular block performance

The Definition of Block “Success” in the Contemporary Literature

Contact Info

Product

Resources

About