[The axillary brachial plexus block. A study of 178 patients]

Success rates and complications were studied in 178 patients scheduled for brachial block. METHODS. Patients of both sexes aged 9 to 79 years received axillary blocks in order to permit typical surgical procedures of the hand an forearm. The block was performed using the transarterial method described be Dejong. Half of the local anesthetic was administered anterior to and half posterior to the axillary artery. The incidence of successful blocks, latency time, and systemic complications were investigated; 14 days after the blocks, motor function and sensation were examined in order to evaluate the local neurological status. RESULTS. The rate of successful blocks averaged 79% using 40 ml 1% mepivacaine after 12 min latency; this rate was increased to 89% by administering a further 20 ml 1% mepivacaine. Disagreeable sensations from the operative field occurred in 5% and mild symptoms of cerebral toxicity in 2.8% of cases; 1.6% of patients had cardiovascular disturbances such as hypotension or arrhythmias. Local complications such as hematomas were found in 17.5% local pain in the axillary region in 15%, and long-lasting paresthesias in 12% of cases. DISCUSSION AND CONCLUSIONS. The 90% rate of successful blocks is comparable to the range of 86-98% presented in the literature. The success rate depends on the definition of successful block, the experience of the anesthetist, and the volume and concentration of the anesthetic solution administered. The incidence of systemic cardiovascular complications was similar to that in the literature, but we observed fewer symptoms of cerebral toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)