Electrostimulation with or without ultrasound-guidance in interscalene brachial plexus block for shoulder surgery

In a prospective controlled trial to compare conventional interscalene brachial plexus block (ISBPB) using anatomic landmarks and electro-stimulation with a combined technique of ultrasound guidance followed by nerve stimulation, 60 patients were randomized into 2 matched equal groups: Group A using...

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Bibliographic Details
Published in:Journal of anesthesia 2012-08, Vol.26 (4), p.610-613
Main Authors: Salem, Mohamed H., Winckelmann, Jörg, Geiger, Peter, Mehrkens, Hans-Hinrich, Salem, Khaled H.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analgesia
Anesthesiology
Anesthetics, Local - administration & dosage
Brachial Plexus - diagnostic imaging
Brachial Plexus - physiology
Conscious Sedation
Critical Care Medicine
Electric Stimulation
Emergency Medicine
Female
Humans
Hypnotics and Sedatives
Intensive
Male
Medicine
Medicine & Public Health
Midazolam
Middle Aged
Muscle, Skeletal - physiology
Nerve Block - methods
Orthopedic Procedures
Orthopedic surgery
Pain Medicine
Propofol
Prospective Studies
Short Communication
Shoulder - surgery
Treatment Outcome
Ultrasonography
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Description
Summary:In a prospective controlled trial to compare conventional interscalene brachial plexus block (ISBPB) using anatomic landmarks and electro-stimulation with a combined technique of ultrasound guidance followed by nerve stimulation, 60 patients were randomized into 2 matched equal groups: Group A using nerve stimulation (NS) alone and Group B using the combination of ultrasound and NS. The time to detect the plexus (3.9 ± 4 min in Group A and 3.3 ± 1.4 min in Group B) was not significantly different. We needed to reposition the needle once ( n  = 13) or twice ( n  = 4) in Group B. First-shot motor response was achieved in all but one patient in Group A; here we were only able to locate the plexus by use of ultrasound. None of the patients needed general anaesthesia. There were no significant differences between postoperative pain, motor power, or patient’s satisfaction. ISBPB seems similarly effective using electro-stimulation and ultrasound if performed by experienced anesthesiologists.
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-012-1366-x