<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator.<bold>Objectives</bold>: The evaluation of ultrasound efficiency as an auxiliary method for brachial plexus block performance, in terms of success rate, vascular punctures. The influence of obesity on performing time, total duration of the block, and success rate of brachial plexus block.<bold>Material and method</bold>: Prospective, randomized study which enrolled adult patients, scheduled for surgical emergency or elective surgical intervention on upper limb with brachial plexus block by axillary approach, using either the peripheral nerve stimulation or the ultrasound guidance.<bold>Results</bold>: We enrolled 160 patients, grouped in two sets- the ultrasound group= 82 patients (US) the neurostimulation group = 78 patients (NS). Vascular punctures were statistically significant different p= 0, 04. The success rate was not influenced by the obesity.<bold>Conclusions</bold>: Ultrasound guidance makes axillary brachial plexus block safer, we can recommend ultrasound guidance as routine for axillary brachial plexus block. The obese patient can beneficiate by both methods of brachial plexus blockage.</abstract>

Introduction: There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator.Objectives: The evaluation of ultrasound efficiency as an auxiliary method for brachial plexus block performance, in terms of success rate, vascular punctures. The influence of obesity on performing time, total duration of the block, and success rate of brachial plexus block.Material and method: Prospective, randomized study which enrolled adult patients, scheduled for surgical emergency or elective surgical intervention on upper limb with brachial plexus block by axillary approach, using either the peripheral nerve stimulation or the ultrasound guidance.Results: We enrolled 160 patients, grouped in two sets- the ultrasound group= 82 patients (US) the neurostimulation group = 78 patients (NS). Vascular punctures were statistically significant different p= 0, 04. The success rate was not influenced by the obesity.Conclusions: Ultrasound guidance makes axillary brachial plexus block safer, we can recommend ultrasound guidance as routine for axillary brachial plexus block. The obese patient can beneficiate by both methods of brachial plexus blockage.

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

University of Medicine and Pharmacy Tîrgu Mureș

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction: There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the...

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Publicado en línea: 23 sept 2017

Páginas: 147 - 151

Recibido: 04 jun 2017

Aceptado: 18 jul 2017

DOI: https://doi.org/10.1515/amma-2017-0025

Palabras clave
brachial plexus block, ultrasound, neurostimulation, obesity, vascular punctures

© 2017 Alexandra Lazar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

Publicado en línea: 23 sept 2017

Páginas: 147 - 151

Recibido: 04 jun 2017

Aceptado: 18 jul 2017

DOI: https://doi.org/10.1515/amma-2017-0025

Palabras clavebrachial plexus block, ultrasound, neurostimulation, obesity, vascular punctures

© 2017 Alexandra Lazar et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Palabras clave
brachial plexus block, ultrasound, neurostimulation, obesity, vascular punctures