Related Experiment Videos
Transarterial techniques are not effective for subclavian perivascular block
R Hickey1, J Hoffman, S Ramamurthy
1Department of Anesthesiology, University of Texas Health Science Center, San Antonio 78284-7838.
Regional Anesthesia
|September 1, 1990
Summary
Transarterial subclavian perivascular block techniques showed low efficacy for brachial plexus anesthesia, frequently requiring supplemental blocks. Complications like phrenic nerve block were common, despite safe serum lidocaine levels.
Area of Science:
- Anesthesiology
- Vascular Procedures
- Regional Anesthesia
Background:
- Transarterial techniques are common for axillary blocks.
- Their application to subclavian perivascular blocks is not well-documented.
Purpose of the Study:
- To evaluate the efficacy and complications of two transarterial techniques for subclavian perivascular block.
- To compare injecting above versus through the subclavian artery.
Main Methods:
- Two groups (n=10 and n=8) received subclavian perivascular blocks using lidocaine 1.5% with epinephrine.
- Group 1: injection after needle withdrawal from the artery (top).
- Group 2: injection after advancing through the artery (bottom).
Main Results:
- Both techniques yielded low rates of anesthesia across brachial plexus dermatomes (≤50%).
- Supplemental blocks were frequently needed (60% in Group 1, 63% in Group 2).
- High incidence of complications: phrenic nerve block (75-80%), hematoma (12-20%), recurrent laryngeal nerve block (10-25%), Horner's syndrome (0-20%).
Conclusions:
- Transarterial subclavian perivascular block techniques demonstrated limited efficacy for comprehensive brachial plexus anesthesia.
- The high rate of necessary supplemental blocks and frequent complications suggest these methods are not optimal.
- Further investigation was halted due to poor outcomes.