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Related Experiment Videos

Axillary plexus block using a peripheral nerve stimulator: single or multiple injections.

J Lavoie1, R Martin, J P Tétrault

  • 1Department of Anaesthesia, University of Sherbrooke, P. Qué., Canada.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|July 1, 1992
PubMed
Summary
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Targeting multiple nerves during axillary brachial plexus block with a peripheral nerve stimulator significantly improves success rates. Stimulating two or four major nerves is more effective than blocking just one for upper limb surgery.

Area of Science:

  • Anesthesiology
  • Surgical Procedures
  • Nerve Blocks

Background:

  • Axillary brachial plexus block is a common anesthetic technique for upper limb surgery.
  • Peripheral nerve stimulators enhance the accuracy of nerve localization during blocks.
  • Optimizing nerve targeting is crucial for achieving successful anesthesia and reducing complications.

Purpose of the Study:

  • To evaluate the success rates of axillary brachial plexus block using a peripheral nerve stimulator.
  • To compare the efficacy of locating one, two, or four major nerves of the brachial plexus.
  • To determine the optimal number of nerves to stimulate for successful block completion.

Main Methods:

  • Prospective, randomized, double-blind study involving 75 patients undergoing upper limb surgery.

Related Experiment Videos

  • Patients were allocated to five groups based on the number and type of nerves targeted (one, two, or four major nerves).
  • Sensory block assessed by Wartenberg Pinwheel testing; block completion required before surgery if anesthesia was incomplete.

    • Main Results:

    • Groups targeting all four nerves (G-1) or the musculo-cutaneous plus one other nerve (G-2) showed significantly higher success rates.
    • Only 1/15 patients in G-1 and G-2 required block completion.
    • Groups targeting only one nerve (G-3, G-4, G-5) had higher rates of incomplete block (7/15 to 8/15, P < 0.01).

    Conclusions:

    • Stimulating the musculo-cutaneous nerve and at least one other major nerve, or all four major nerves, leads to higher success rates in axillary brachial plexus blocks.
    • Targeting a single nerve is less effective than targeting multiple nerves for successful anesthesia.
    • Peripheral nerve stimulation guidance for axillary blocks is optimized by targeting at least two major nerves.