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Axillary approach versus the infraclavicular approach in ultrasound-guided brachial plexus block: comparison of anesthetic time. | LitMetric

AI Article Synopsis

  • The study compared two techniques for brachial plexus block (BPB) under ultrasound guidance: axillary BPB and infraclavicular BPB, focusing on their effectiveness and performance time.
  • Twenty-two patients undergoing forearm surgery were randomly assigned to either group AX (axillary) or group IC (infraclavicular) and evaluated based on block onset and performance time after receiving a specific anesthetic mix.
  • Results showed that the infraclavicular BPB had a shorter performance time compared to the axillary approach, but took longer for the block to start working, highlighting the trade-off between speed and onset time.

Article Abstract

Background: With ultrasound guidance, the success rate of brachial plexus block (BPB) is 95-100% and the anesthetic time has become a more important factor than before. Many investigators have compared ultrasound guidance with the nerve stimulation technique, but there are few studies comparing different approaches via the same ultrasound guidance. We compared the axillary BPB with the infraclavicular BPB under ultrasound guidance.

Methods: Twenty-two ASA physical status I-II patients presenting with elective forearm surgery were prospectively randomized to receive an axillary BPB (group AX) or an infraclavicular BPB (group IC) with ultrasound guidance. Both groups received a total of 20 ml of 1.5% lidocaine with 5 µg/ml epinephrine and 0.1 mEq/ml sodium bicarbonate. Patients were then evaluated for block onset and block performance time was also recorded.

Results: Group IC demonstrated a reduction in performance time vs. group AX (622 ± 139 sec vs. 789 ± 131 sec, P < 0.05). But, the onset time was longer in group IC than in group AX (7.7 ± 8.8 min vs. 1.4 ± 2.3 min, P < 0.05). All blocks were successful in both groups.

Conclusions: Under ultrasound guidance, infraclavicular BPB was faster to perform than the axillary approach. But the block onset was slower with the infraclavicular approach.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155130PMC
http://dx.doi.org/10.4097/kjae.2011.61.1.12DOI Listing

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