Regional anesthesia for upper extremity surgery--our experience.

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Procedures

Background:

• The axillary approach to brachial plexus block is a common regional anesthesia technique for upper extremity surgery.
• Conventional methods often rely on paresthesia or nerve stimulation to guide needle placement.

Purpose of the Study:

• To evaluate the efficacy and safety of a perivascular brachial plexus block using the axillary approach without paresthesia or nerve stimulation.
• To assess the success rate, onset time, and complication incidence of this modified technique.

Main Methods:

• A retrospective review of 158 patients undergoing upper extremity surgery under brachial plexus block via axillary approach.
• Local anesthetic (lidocaine 2% and bupivacaine 0.5%) injected into the neurovascular sheath adjacent to the axillary artery based on pulsation.
• No paresthesia or nerve stimulator used for needle localization.

Main Results:

• Successful anesthesia was achieved in 135 (85.0%) patients with the brachial plexus block alone.
• 12.5% of patients required supplemental anesthesia.
• No significant complications were attributed to the anesthetic technique.

Conclusions:

• The perivascular axillary brachial plexus block is a simple, safe, and effective method for regional anesthesia in upper extremity surgery.
• This technique offers a viable alternative to traditional methods, potentially reducing procedure time and patient discomfort.