Low-Concentration Brachial Plexus Block

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Procedures

Background:

• Traditional brachial plexus blocks can limit intraoperative patient mobility.
• A novel low-concentration brachial plexus block (LCBB) was developed to permit active patient motion during surgery.
• This technique aims to block only sensory nerves, preserving motor function.

Purpose of the Study:

• To evaluate the efficacy of the low-concentration brachial plexus block (LCBB) for enabling intraoperative active motion.
• To assess the safety and effectiveness of LCBB in a surgical setting.

Main Methods:

• Thirty-eight patients received ultrasound-guided supraclavicular brachial plexus blocks with 0.6 mg/ml ropivacaine.
• Local anesthetic infiltration was administered for insufficient pain relief.
• Intraoperative active motion was assessed via manual muscle testing (≥grade 4).

Main Results:

• LCBB was successful in 94.7% of cases (36 of 38 patients).
• 91% of patients achieved manual muscle testing of grade 4 or higher.
• Additional local anesthetic was required in 61.1% of cases, with a mean volume of 8.7 mL.

Conclusions:

• Low-concentration brachial plexus block is a viable anesthesia method for facilitating intraoperative active motion.
• While supplementary local anesthetic may be needed, LCBB allows for effective tourniquet use and patient movement.
• This technique offers a promising alternative for specific surgical procedures requiring intraoperative assessment of active motion.