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Axillary block in children: single or multiple injection?

P Carre1, A Joly, B Cluzel Field

  • 1Department of Anesthesiology, University of Rennes, France.

Paediatric Anaesthesia
|January 13, 2000
PubMed
Summary
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Multiple fractionated doses for pediatric axillary blocks did not improve block quality compared to single injections. However, fractionated doses led to a faster onset of the block in children, particularly younger ones.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Regional Anesthesia

Background:

  • Axillary block is a common regional anesthesia technique in children.
  • Optimizing the onset and quality of axillary blocks is crucial for pediatric surgical procedures.

Purpose of the Study:

  • To compare the efficacy of single versus multiple fractionated doses of lignocaine with adrenaline for pediatric axillary blocks.
  • To evaluate the impact on motor and sensory block onset time and quality.

Main Methods:

  • A double-blind prospective study involving 70 children undergoing axillary blocks.
  • Comparison of a single injection (Group S) versus multiple fractionated doses (Group M) of local anesthetic.
  • Brachial plexus identification using a peripheral nerve stimulator and assessment via Lanz's scale.

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Main Results:

  • No significant difference in overall motor and sensory block quality between single and fractionated doses.
  • Multiple fractionated doses resulted in a faster onset of block (25 min vs. 29 min).
  • Younger children (5-9 years) experienced a faster onset with fractionated doses.

Conclusions:

  • Fractionated doses do not enhance the quality of sensory and motor block in children compared to single injections.
  • Faster onset of block was observed with fractionated doses, especially in younger pediatric patients.
  • Selective block of the musculocutaneous nerve is advised for procedures in its territory.