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. 2013 Apr;64(4):327-33.
doi: 10.4097/kjae.2013.64.4.327. Epub 2013 Apr 22.

Ultrasound does not shorten the duration of procedure but provides a faster sensory and motor block onset in comparison to nerve stimulator in infraclavicular brachial plexus block

Walid Trabelsi  1 , Mondher Belhaj Amor, Mohamed Anis Lebbi, Chiheb Romdhani, Sami Dhahri, Mustapha Ferjani
Affiliations

Ultrasound does not shorten the duration of procedure but provides a faster sensory and motor block onset in comparison to nerve stimulator in infraclavicular brachial plexus block

Walid Trabelsi et al. Korean J Anesthesiol. 2013 Apr.

Abstract

Background: Infraclaviculr Brachial plexus (ICBP) block is useful for upper extremity surgery. The aim of this study was to compare the ultrasound (US) technique with the nerve stimulation (NS) technique in their success rates and times to perform ICBP block.

Methods: 60 patients undergoing surgery of the upper limb were randomly allocated into two groups (n = 30 per group). Group 1; US, and Group 2; NS. Procedure time (including time for initial ultrasound examination), the success rate and the onset time of sensory and motor blockade were assessed.

Results: The time needed to perform the ICBP block is similar in both groups (220 seconds ± 130 in US group versus 281 ± 134 seconds in NS group; P = 0.74). The success rate of all the nerve blocks in the US group was 100%. The success rate in the NS group was 73.3%, 76.7%, 76.7% and 100% for radial, ulnar, medial, and musculocutaneous nerve, respectively. A significantly faster onset of sensory block for the radial, ulnar, median, musculocutaneous, and the four nerves considered together were observed. The onset of motor block for the radial, ulnar, and medial nerves was faster in the US group. However, the onset of motor block for the musculocutaneous nerve and the four nerves considered together was comparable between the two groups.

Conclusions: The ultrasound-guided infraclavicular brachial plexus block is a significantly efficacious method with faster onset but similar procedure time compared to the nerve stimulation technique.

Keywords: Brachial plexus; Bupivacaine; Ultrasound.

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Figures

Fig. 1
Fig. 1
Percentage of patients with sensory block success over time for each nerve and for the four nerves considered together. *P < 0.05.
Fig. 2
Fig. 2
Percentage of patients with motor block success over time for each nerve and for the four nerves considered together. *P < 0.05.
Fig. 3
Fig. 3
Median onset of sensory block for each nerve and for the four nerves considered together. Error bars show interquartile range. *P < 0.05.
Fig. 4
Fig. 4
Median onset of motor block for each nerve and for the four nerves considered together. Error bars show interquartile range. *P < 0.05.
Fig. 5
Fig. 5
Ultrasonography of infraclavicular region. 1: skin, 2: pectoralis major, 3: pectoralis minor, 4: axillary artery, 5: axillary vein, 6: lateral cord, 7: posterior cord, 8: medial cord.
Fig. 6
Fig. 6
Needle (arrows) trajectory during ultrasound guided infraclavicular brachial plexus block. 4: axillary artery, 6: lateral cord, 7: posterior cord, 8: medial cord.
See this image and copyright information in PMC

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