Axillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection...

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Peripheral Nerve Blocks

Background:

• The multiple-injection axillary block technique demonstrates high success rates for brachial plexus anesthesia.
• This method can be time-consuming and technically demanding.
• Simplified techniques with fewer injections may offer advantages.

Purpose of the Study:

• To compare the efficacy and efficiency of a 2-injection versus a 3-injection axillary block technique.
• To evaluate the success rate of blocking specific nerves (radial, median, musculocutaneous, ulnar) and achieving a complete block.

Main Methods:

• A double-blind study involving 100 patients randomly assigned to either a 2-injection (radial, median nerves) or 3-injection (radial, median, musculocutaneous nerves) group.
• All injections utilized 40 mL of local anesthetic and nerve stimulation for localization.

Main Results:

• The 3-injection group showed a significantly higher success rate for blocking the musculocutaneous nerve (98% vs. 80%).
• No significant differences were observed in blocking the radial, median, and ulnar nerves between groups.
• Complete block rates were higher in the 3-injection group (90% vs. 76%), but the 2-injection technique was faster (5 vs. 6 minutes).

Conclusions:

• The 2-injection technique is a viable alternative for achieving anesthesia in the hand, comparable to the 3-injection method.
• The 3-injection technique remains essential when the musculocutaneous nerve's distribution is relevant to the surgical site.