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Related Experiment Videos

Continuous axillary brachial plexus block--a clinical and anatomical study.

E T Ang, B Lassale, G Goldfarb

    Anesthesia and Analgesia
    |July 1, 1984
    PubMed
    Summary

    A novel catheter insertion technique for continuous axillary brachial plexus block significantly reduces failure and arterial puncture rates. This safe method ensures effective nerve blockade for prolonged surgeries and improved postoperative physiotherapy.

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    Area of Science:

    • Anesthesiology
    • Regional Anesthesia
    • Surgical Techniques

    Background:

    • Continuous axillary brachial plexus block is crucial for prolonged surgeries.
    • Existing techniques carry risks of failure and inadvertent arterial puncture.
    • A need exists for a safer, more effective catheter insertion method.

    Purpose of the Study:

    • To evaluate a new catheter insertion technique for continuous axillary brachial plexus block.
    • To assess the safety and efficacy of this novel approach.
    • To reduce complications associated with traditional methods.

    Main Methods:

    • A new technique involving catheter insertion 40-mm below the axilla, medial to the biceps muscle, was studied in 52 patients and 12 cadavers.
    • The arm was positioned in abduction, external rotation, and elbow flexion.

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  • Lidocaine and bupivacaine were used for nerve blockade.

    • Main Results:

    • Successful sensory and motor blockade of targeted nerves was achieved in 98% of patients.
    • Only one instance of arterial puncture occurred.
    • Catheter dwell time up to 9 days showed no complications.
    • Anatomical study revealed the catheter tip resided in a superficial virtual cavity, not the perivascular sheath.

    Conclusions:

    • The new technique is safe and highly effective for continuous axillary brachial plexus block.
    • It offers a significant reduction in failure and arterial puncture rates.
    • This method is beneficial for long operations and facilitating postoperative physiotherapy.