AI Article Synopsis
- Nerve block anesthesia is effective for upper limb surgeries, and this study compared perineural (PN) and perivascular (PV) techniques for axillary brachial plexus block using ultrasound.
- The study involved 66 participants, with the PN technique taking longer (7.82 min) and requiring more needle passes (66.7% needed 4 passes), while the PV group had a quicker time (4.79 min) and fewer passes (81.8% needed only 2 passes).
- Although both techniques had similar success rates (100% for PN and 93.9% for PV), the PV technique is suggested as preferable for busy surgical units due to its efficiency.
Article Abstract
Background: Nerve block anesthesia is a common regional anesthesia used for upper limb surgeries because of its ability to target the operative site and provision of impressive postanesthetic pain relief. This randomized, single-blinded study compared the quality of block of the perineural (PN) and perivascular (PV) techniques of axillary brachial plexus block under ultrasound guidance.
Methods: Sixty-six participants were recruited into either PV or PN groups. The local anesthetic (LA) comprised 14 ml of 0.5% bupivacaine, 14 ml of 1% lidocaine, and 2 ml of dexmedetomidine (50 μg/ml). Under ultrasound guidance, 6 ml of LA was deposited around the musculocutaneous nerve for both groups. For the PV group, 24 ml was deposited dorsal to the axillary artery while 8 ml each was deposited around median, radial, and ulnar nerves for the PN group.
Results: The mean total procedure time in PN group was significantly longer than in the PV group (7.82 ± 0.95 min vs. 4.79 ± 1.11 min; P = 0.001). Participants in the PN group required more needle passes (66.7% required 4 passes while 81.8% required only 2 passes in the PV group). The success rate was 100% in PN group and 93.9% in PV group (P = 0.49).
Conclusion: The PV and PN techniques were comparable in terms of their success rates and total anesthesia-related times. The PN technique had higher success rate and faster block onset, but the PV provided a quicker performance time and fewer needle passes. Hence, PV technique may be preferable to PN for high-volume surgical units.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445704 | PMC |
| http://dx.doi.org/10.4103/aam.aam_224_21 | DOI Listing |
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