Our experiences with a single injection axillary block technique

Abstract

OBJECTIVE:Axillary plexus block is one of the widely used technique for upper extremity surgery. In this study, we retrospectively evaluated the single injection axillary plexus block technique we used in our rutine anesthesia practice, between August 2010-March 2011.METHODS:Medical records of ASA I-III, 40 17 female and 23 male patients who underwent elective single injection axillary block performed by neurostimulation technique in elective distal part of the arm, forearm and hand surgeries were evaluated, retrospectively. Axillary block was performed with a nerve stimulator, and a 22 G, 50 mm insolated needle. The needle was inserted immediately superior to axillary artery, advanced through the lateral border of the pectoralis major muscle and to the most proximal part of the axilla. The local anesthetic mixture (1% lidocaine 20 ml + 0.25% bupivacaine 15 ml) was injected to the place (point) where the distal motor responses of the median and ulnar nerves were elicited at the same time, before dropping the stimulation current down to 0.5 mA. In our study, demographic data, motor and sensory block times, the success rate and the complications of the block were evaluated.RESULTS:The mean block performance time was 1.21±0.39 min in our 40 patients. The onset time of the motor block was 14.20±4.96 min and the sensory block was 17.19±2.71 min, respectively. The success rate of the block was 97.5 percent. No complication was found during 24 hours postoperatively. The sensory and motor functions returned properly in all patients.CONCLUSION:In our study we found that the single injection axillary block tecnique was easy to perform with its higher success, and lower complication rates. Therefore we concluded that axillary block should be supported in appropriate cases.

Peripheral Nerve Stimulator (PNS) Versus Trans-Arterial (TA) Techniques for Axillary Brachial Plexus Block

“…[8] The PNS techniques has the possibility of inadvertent neurovascular damage. [9] Yanil et al [13] in their single injection axillary block technique, concluded that it was more advantageous than multiple injection. The success rate for an axillary block depends on the definition of a successful block (i.e., surgical anesthesia versus blockade of all four terminal nerves of the upper extremity), the technique used to localize the brachial plexus, and the number of injections.…”

Comparison of the Effect of Intercostobrachial Nerve Block with and Without Ultrasound Guidance on Tourniquet Pain After Axillary Block of Brachial Plexus: A Randomized Clinical Trial

“…Brachial plexus block in upper limb surgeries is performed with different techniques (neurostimulation, US, or transarterial) depending on where the brachial plexus is available (intersca-lene, supraclavicular, infraclavicular, axillary, and humeral canal) (3). Because the 3 main nerves of this plexus, which are the main nerves of the upper extremity, are surrounded by a sheath of connective tissue in the axilla, filling this sheath with a single injection of local anesthetic (LA) can provide safe, rapid, and effective anesthesia in the upper extremities during forearm and hand surgeries (4). On the other hand, blocking the brachial plexus in the axilla area has no side effects (such as pneumothorax, phrenic nerve injury, and recurrent laryngeal nerve injury), occurring in other methods of blocking this plexus (5).…”