Percutaneous central venous catheterization in small infants: axillary block can facilitate the insertion rate

Central venous cannulation through a peripheral vein is the technique of choice in awake nonsedated critically ill infants. Such a technique has a high failure rate. We undertook a retrospective study to determine whether a brachial plexus block performed via the axillary approach could improve the success rate for the insertion of a central venous catheter from a peripheral vein of the upper limb in small infants. Data from 128 infants, submitted or not submitted to the axillary block, were analysed. The failure rate for insertion of the central venous catheter was 27% in the group without the use of the axillary block and 9% with the axillary block (P<0.05). The use of brachial plexus block via the axillary route, although evaluated retrospectively, improves the success rate for the insertion of small diameter central venous silicon catheter from a peripheral vein of the upper limb in small infants.