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

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....

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Bibliographic Details
Published in:Canadian journal of anesthesia 2009-11, Vol.56 (11), p.812-818
Main Authors: Brull, Richard, Lupu, Mario, Perlas, Anahi, Chan, Vincent W. S., McCartney, Colin J. L.
Format: Article
Language:English
Subjects:
Adult
Anesthesiology
Anesthetics, Local - administration & dosage
Brachial Plexus
Bupivacaine - administration & dosage
Cardiology
Clinical trials
Critical Care Medicine
Double-Blind Method
Electric Stimulation - adverse effects
Electric Stimulation - methods
Epinephrine - administration & dosage
Female
Hand surgery
Humans
Intensive
Lidocaine - administration & dosage
Male
Medicine
Medicine & Public Health
Middle Aged
Nerve Block - adverse effects
Nerve Block - methods
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Postoperative Complications
Prospective Studies
Regional anesthesia
Reports of Original Investigations
Success
Surgery
Time Factors
Ultrasonic imaging
Ultrasonography, Interventional - methods
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Summary: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  
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-009-9170-2