[Ultrasound-guided axillary block versus ultrasound-guided infraclavicular block for upper extremity surgery]. 2013

S López-Morales, and A Moreno-Martín, and J D Leal del Ojo, and F Rodriguez-Huertas
Servicio de Anestesiología y Reanimación, Hospital General de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España. sabinalopez@hotmail.com

BACKGROUND Most upper limb regional anaesthesia techniques are successful, and differences in efficacy should dictate the choice of technique. METHODS This prospective, randomised study compares ultrasound-guided infraclavicular (IB) and ultrasound-guided axillary brachial plexus blocks (AB) for upper limb surgery. Anaesthesia time (performance time and onset time) was the primary outcome measure. The success rate (surgical anaesthesia), analgesia duration, postoperative pain scores, and the incidence of complications over the following 24h were recorded. RESULTS A total of 82 patients were included in the study, and received either IB (n=42) or AB (n=40). No differences were observed between the 2 groups in terms of total anaesthesia-related time, performance time, success rate (90-95%), or postoperative pain scores. Compared with the infraclavicular approach, ultrasound-guided AB group required a longer onset time, 10.2min (SD±1.4), than IB group, 6.35min (SD±2). IB was also associated with a longer analgesia duration than that of AB; 20h (SD±1.36) versus 13.70h (SD±2.16), respectively. The only complications we observed were uneventful vascular punctures. CONCLUSIONS We can conclude that compared to ultrasound-guided AB, ultrasound-guided IB provides a similar efficacy, a shorter onset time and longer lasting analgesia.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002968 Clavicle A bone on the ventral side of the shoulder girdle, which in humans is commonly called the collar bone. Collar Bone,Bone, Collar,Bones, Collar,Clavicles,Collar Bones
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001365 Axilla Area of the human body underneath the SHOULDER JOINT, also known as the armpit or underarm. Armpit,Underarm
D018084 Ultrasonography, Interventional The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions. Ultrasonography, Intravascular,Ultrasound, Interventional,Interventional Ultrasonography,Intravascular Ultrasonography,Interventional Ultrasound
D034941 Upper Extremity The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER. Extremity, Upper,Membrum superius,Upper Limb,Extremities, Upper,Limb, Upper,Limbs, Upper,Upper Extremities,Upper Limbs

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