Procedural pain of an ultrasound‐guided brachial plexus block: a comparison of axillary and infraclavicular approaches

Frederiksen, B. S.; Koscielniak-Nielsen, Zbigniew J.; Jacobsen, Ramunė; Rasmussen, Henrik; Hesselbjerg, L.

doi:10.1111/j.1399-6576.2009.02197.x

Cited by 29 publications

(32 citation statements)

References 19 publications

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“…Twenty-nine studies compared US against another nerve localization method, 7-35 of which 10 were published since the first iteration of this article. [7][8][9][10][11][12]15,16,18,19 Seventeen studies compared 2 (or more) different US-guided approaches, [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] with 11 new articles published since August 2009. [36][37][38][39][40][41][42][43][44]46,49 The median Jadad score for included articles was 3.…”

Section: Resultsmentioning

confidence: 99%

Evidence Base for the Use of Ultrasound for Upper Extremity Blocks

Choi

McCartney

2016

Regional Anesthesia and Pain Medicine

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This article reviews and summarizes randomized, controlled studies that have assessed ultrasound (US) guidance for brachial plexus blocks in comparison with other nerve localization methods as well as those that have compared different US-guided brachial plexus block techniques. Both PubMed and EMBASE databases were searched using the MeSH terms anesthetic technique, brachial plexus, and ultrasound. Studies were included if they had randomized allocation comparing US with another conventional nerve localization technique or if they compared 2 different US-guided techniques, such as single versus multiple injections. Each study was classified as a categorical outcome as being supportive, unclear, or negative for the use of US. These were compared with χ analysis with the null hypothesis that US provides no benefit for brachial plexus blocks. Forty-seven studies met the inclusion criteria, and 29 compared US guidance to landmark or peripheral nerve stimulation techniques. Our analysis of the literature supports the use of US over other nerve localization techniques as being beneficial for several block performance outcomes including block performance time, reducing the number of needle passes and the incidence of vascular puncture, shortening sensory block onset time, and improving block success.

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Section: Resultsmentioning

confidence: 99%

Evidence Base for the Use of Ultrasound for Upper Extremity Blocks

Choi

McCartney

2016

Regional Anesthesia and Pain Medicine

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“…2). Nine trials used regional anaesthesia alone [7-9, 30, 33, 35, 36, 39, 40], one trial also used general anaesthesia [42], nine trials sedated with propofol [6,11,23,26,28,29,32,34,37] and six sedated with midazolam and an opioid [10,22,27,31,38,41].…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen trials compared different brachial plexus approaches: axillary vs infraclavicular [8,31,35,42]; axillary vs supraclavicular [38,39]; infraclavicular vs Figure 2 Risks of bias in seven methodological domains for each trial, categorised as: low (green); unclear (yellow); or high (red). supraclavicular [7,26,28,33,36,37,41]; and one trial compared the three approaches [6].…”

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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“…An investigation was performed with the primary aim to assess procedurerelated pain during block placement and look to recognize the cause(s) [26]. The authors compared procedural pain from patients randomized to either an axillary or infraclavicular block and results showed that the in-plane axillary approach took a longer time to perform and required more needle passes.…”

Section: Brachial Plexus Blockade: Single or Multiple Injection Sitesmentioning

confidence: 99%