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Single- versus double-injection costoclavicular block: a randomized comparison.

Sebastián Layera1, Julián Aliste2, Daniela Bravo1

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Summary
This summary is machine-generated.

The double-injection ultrasound-guided costoclavicular block significantly reduces anesthesia onset time for upper limb surgery compared to the single-injection technique. This method offers a faster and potentially more efficient approach to regional anesthesia.

Keywords:
brachial plexusregional anesthesiaupper extremity

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia
  • Ultrasound-Guided Procedures

Background:

  • The costoclavicular approach targets the brachial plexus in the proximal infraclavicular fossa.
  • This area involves the convergence of the lateral, medial, and posterior cords of the brachial plexus.

Purpose of the Study:

  • To compare the onset time of single-injection versus double-injection ultrasound-guided costoclavicular blocks.
  • To evaluate the efficacy and safety of the double-injection technique for brachial plexus anesthesia.

Main Methods:

  • A randomized trial involving 90 patients undergoing upper limb surgery.
  • Patients received either a single- (n=45) or double-injection (n=45) ultrasound-guided costoclavicular block.
  • Onset time, success rate, and pain scores were primary outcomes; performance time and needle passes were also recorded.

Main Results:

  • The double-injection technique showed a significantly shorter onset time (16.6 min vs 23.4 min) compared to the single-injection technique.
  • Total anesthesia-related time was also reduced with the double-injection method (22.5 min vs 28.9 min).
  • No significant differences were observed in success rates or technical execution, though more needle passes were required for the double-injection group.

Conclusions:

  • Double-injection costoclavicular block provides a faster onset and shorter total anesthesia time than the single-injection technique.
  • Further research into triple-injection techniques may offer even faster onset times for brachial plexus anesthesia.