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Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Techniques: Perineural Injection versus Single or Double Perivascular Infiltration

Title
Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Techniques: Perineural Injection versus Single or Double Perivascular Infiltration
Authors
Cho, SooyoungKim, Youn JinBaik, Hee JungKim, Jong HakWoo, Jae Hee
Ewha Authors
김종학김윤진우재희박희정
SCOPUS Author ID
김종학scopus; 김윤진scopus; 우재희scopus
Issue Date
2015
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
0513-5796JCR Link1976-2437JCR Link
Citation
vol. 56, no. 3, pp. 838 - 844
Keywords
Brachial plexusnerve blockultrasonography
Publisher
YONSEI UNIV COLL MEDICINE
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: We compared three methods of ultrasound-guided axillary brachial plexus block, which were single, and double perivascular (PV) infiltration techniques, and a perineural (PN) injection technique. Materials and Methods: 78 patients of American Society of Anesthesiologists physical status I-II undergoing surgery of the forearm, wrist, or hand were randomly allocated to three groups. 2% lidocaine with epinephrine 5 mu g/mL was used. The PN group (n=26) received injections at the median, ulnar, and radial nerve with 8 mL for each nerve. The PV1 group (n=26) received a single injection of 24 mL at 12-o'clock position of the axillary artery. The PV2 group (n=26) received two injections of 12 mL each at 12-o'clock and 6-o'clock position. For all groups, musculocutaneous nerve was blocked separately. Results: The PN group (391.2 +/- 171.6 sec) had the longest anesthetic procedure duration than PV1 (192.8 +/- 59.0 sec) and PV2 (211.4 +/- 58.6 sec). There were no differences in onset time. The average induction time was longer in PN group (673.4 +/- 149.6 sec) than PV1 (557.6 +/- 194.9 sec) and PV2 (561.5 +/- 129.8 sec). There were no differences in the success rate (89.7% vs. 86.2% vs. 89.7%). Conclusion: The PV injection technique consisting of a single injection in 12-o'clock position above the axillary artery in addition to a musculocutaneous nerve block is equally effective and less time consuming than the PN technique. Therefore, the PV technique is an alternative method that may be used in busy clinics or for difficult cases.
DOI
10.3349/ymj.2015.56.3.838
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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