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Comparison of Ultrasound Versus Ultrasound with Nerve Stimulator-Guided Infraclavicular Block Anesthesia Methods in
Abdulhakim Şengel1, Evren Büyükfirat1, Selçuk Seçilmiş2
1Department of Anesthesiology and Reanimation, Faculty of Medicine, Harran University, 63040 Şanlıurfa, Turkey.
Insights
Ultrasound-guided infraclavicular brachial plexus block (ICB) is effective and safe for pediatric surgeries, offering comparable analgesia to ultrasound with nerve stimulator guidance. This method ensures ease of application and low complication rates in children.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Regional Anesthesia
Background:
- Brachial plexus block is a key anesthesia/analgesia technique for upper extremity surgeries.
- Limited studies exist on pediatric brachial plexus blocks.
- Infraclavicular brachial plexus block (ICB) is effective but requires precise guidance.
Purpose of the Study:
- To retrospectively analyze the efficacy and safety of ultrasound (US)-guided ICB versus ultrasound with nerve stimulator (US + NS)-guided ICB in pediatric patients.
- To compare procedure time, operative time, and analgesic outcomes between the two guidance methods.
Main Methods:
- Retrospective analysis of 240 pediatric patients undergoing ICB between October 2020 and April 2023.
- 120 patients received US-guided ICB, and 120 received US + NS-guided ICB.
- Data collected included procedure/operative times, opioid use, pain scores, and block durations (motor and sensory).
Main Results:
- Demographic data were similar between groups.
- US-guided ICB had a significantly shorter mean procedure time (6.1 min) compared to US + NS-guided ICB (8.31 min) (p < 0.001).
- Mean motor block duration (US: 6.20h vs. US+NS: 6.29h) and sensory block duration (US: 9.38h vs. US+NS: 9.53h) were comparable between groups (p > 0.05).
Conclusions:
- Both US-guided and US + NS-guided ICB are effective and safe for pediatric patients, offering prolonged analgesia and low complication rates.
- US-guided ICB is faster and equally effective as US + NS-guided ICB in skilled hands.
- Further prospective studies with larger cohorts are recommended to confirm these findings.
Abstract:
Background and objectives: Brachial plexus block is one of the most effective anesthesia and analgesia methods for upper extremity surgeries across different age groups. However, the number of studies on this block in children is insufficient. The aim of this study was to retrospectively analyze and discuss the efficacy and safety of ultrasound (US)- and Ultrasound with nerve stimulator (US + NS)-guided infraclavicular brachial plexus block (ICB) in pediatric patients. Materials and Method: In this study, we retrospectively analyzed the data of 240 pediatric patients admitted to our clinic between October 2020 and April 2023, 120 of whom underwent US-guided ICB and 120 who underwent US + NS-guided ICB. Results: Demographic data of both groups who underwent US and US + NS-guided ICB were similar. The mean procedure time was 6.1 ± 0.8 min for the US group and 8.31 ± 0.82 min for the US + NS group (p < 0.001). The mean operative time was 62.4 ± 11.3 min in the US group and 62.4 ± 9.5 min in the US + NS group (p = 0.73). Intraoperative and postoperative opioid and additional analgesia use and pain scores at 1, 3, 6, 9, 12, 15, and 24 h were recorded in both groups. The mean duration of the motor block (MBD) was 6.20 ± 0.95 h in the US group and 6.29 ± 0.88 h in the US + NS group (p = 0.46). The mean duration of sensory block (SBD) was 9.38 ± 2.13 h in the US group and 9.53 ± 2.05 h in the US + NS group (p = 0.38). Conclusions: In pediatric patients, US and US + NS-guided ICB applications are effective and safe in ease of application, prolonged analgesia, and low complication rates. In skilled hands, US-guided ICB can be as effective as US + NS-guided ICB. Further prospective studies with more significant patient populations are needed to validate these findings.
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