Ultrasound guidance improves the success rate of a perivascular axillary plexus block

Sites, Brian D.; Beach, Michael L.; Spence, Brian C.; Wiley, Christopher W.; Shiffrin, Jeffrey S.; Hartman, Gregg S.; Gallagher, John D.

doi:10.1111/j.1399-6576.2006.01042.x

Cited by 157 publications

(90 citation statements)

References 18 publications

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“…Sixth, we believed LA would be better distributed in the SA group within the sheath of axillary brachial plexus, but we did not confirm intra-sheath placement of the needle tip or LA distribution by ultrasound or contrast radiography [1]. Furthermore, we did not consider septae dividing the brachial plexus within the sheath.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, we believe MCN block did not affect our assessment of the effectiveness of TAAB, because MCN sensory block scores were similar in the two study groups (Table 3). In addition, we did not include surgeries of the anterior-lateral forearm, had we done so complete blockade of the MCN would have confounded results regardless of the success of TAAB [1].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, we injected LA immediately after arterial blood flow through the needle ceased by letting a tube be opened to air, to ensure LA was injected as close as possible to the axillary artery [1,5].…”

Section: Discussionmentioning

confidence: 99%

“…The technique used was as follows [1,5]. The patient's arm was extended perpendicular to the body and abducted to expose the axilla, and the elbow was then flexed at 90 degrees.…”

Section: Methodsmentioning

confidence: 99%

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Effect of needle approach to the axillary artery on transarterial axillary brachial plexus block quality

Chang

Lee

Oh³

et al. 2017

Anesth Pain Med

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The technique used was as follows [1,5]. The patient's arm was extended perpendicular to the body and abducted to expose the axilla, and the elbow was then flexed at 90 degrees.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Effect of needle approach to the axillary artery on transarterial axillary brachial plexus block quality

Chang

Lee

Oh³

et al. 2017

Anesth Pain Med

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“…This may explain the lack of difference in success rates between US and neurostimulation (NS). Using a technique relying on multiple injections to achieve circumferential LA spread around the artery, Sites et al 15 compared US guidance to a transarterial technique (with two equal volume injections in front and behind the artery) in 56 patients undergoing hand surgery. Using 35 mL of lidocaine 1.5% with epinephrine 5 µg·mL -1 , these authors found that echoguidance yielded a shorter performance time (7.9 ± 3.9 vs 11.1 ± 5.7 min; P < 0.05) and a lower failure rate, defined as conversion to general anesthesia or the inability to localize the artery (0 vs 28.6% of patients; P = 0.01).…”

Section: Adjunctive Ultrasonography Axillary Block (Axb)mentioning

confidence: 99%

Ultrasonography and stimulating perineural catheters for nerve blocks: a review of the evidence

Tran

Muñoz

Russo

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) offering blinded assessment and sample size justification, in order to determine the benefits associated with adjunctive ultrasonography (US) and stimulating perineural catheters for nerve blocks. Source:The literature search for this review was conducted during the second week of December 2007 using the MEDLINE (January 1950 to November 2007 and EMBASE (January 1980 to November 2007) databases. For US-guided peripheral and neuraxial blocks, the following medical subject heading (MeSH) terms were searched: "nerve block", "epidural anesthesia", "epidural analgesia", "epidural injection", "epidural space", "spinal anesthesia", and "spinal injection", the results were combined with "ultrasonography" (MeSH term) and "ultrasound" (key word). For stimulating perineural catheters, the following MeSH terms were cross referenced with the MeSH term, "nerve block": "peripheral catheterization", "indwelling catheterization", "catheterization", and keywords, "nerve catheter" and "continuous". Subsequently, the result of this search was combined to "stimulating" (key word). Fifteen RCTs, offering blinded assessment and sample size justification, were retained for analysis.Principal findings: For axillary blocks, US guidance yields a higher success rate than a double-injection, transarterial and a triple-injection, neurostimulation-guided technique. Compared to a quadruple-stimulation technique, no major differences can be found. The addition of nerve stimulation to US guidance offers no clear benefits for axillary blocks. For femoral blocks, compared to neurostimulation, echoguidance is associated with a local anesthetic (LA) sparing effect (up to 42%). In children, US guidance yields a LA sparing effect and a longer duration of action for lower extremity nerve blocks.Compared to their blind counterparts, stimulating catheters seem to offer limited clinical benefits. Despite providing a sparing effect on LA and opioid consumption, stimulating catheters are not associated with a decrease in side effects or analgesiarelated expenditures. Conclusions Sources : La recherche de littérature pour cet article de synthèse a été menée la deuxième semaine de décembre 2007 dans les bases de données MEDLINE (janvier 1950 à novembre 2007) et EMBASE (janvier 1980 à novembre 2007). Pour les blocs périphériques et neuraxiaux échoguidés, les termes MeSH suivants ont été recherchés : « nerve block », « epidural anesthesia », « epidural analgesia », « epidural injection », « epidural space », « spinal anesthesia » et « spinal injection », et ont été associés à « ultrasonography »

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Single, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults

Chin

Handoll

2011

Cochrane Database of Systematic Reviews

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Ultrasound guidance improves the success rate of a perivascular axillary plexus block

Abstract: Ultrasonographic guidance improves the overall success rate of axillary blocks in comparison to a transarterial technique.

Cited by 157 publications

References 18 publications

Effect of needle approach to the axillary artery on transarterial axillary brachial plexus block quality

Effect of needle approach to the axillary artery on transarterial axillary brachial plexus block quality

Ultrasonography and stimulating perineural catheters for nerve blocks: a review of the evidence

Single, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults

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