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Comparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block
R Hickey1, J Hoffman, L J Tingle
1Department of Anesthesiology, University of Texas Health Science Center, San Antonio 78284.
Background And Objectives:
This study compared the efficacy of three perivascular techniques of axillary block.
Methods:
In group 1, all of the local anesthetic was injected after advancing the needle through the axillary artery (back of artery, n = 20); in group 2, after withdrawing slightly from the artery (front of artery, n = 20); and in group 3, half of the anesthetic was injected after advancing through and half after withdrawing from the axillary artery (half and half, n = 20). The local anesthetic used for the axillary block was 50 ml of 1.5% mepivacaine with epinephrine 1:200,000.
Results:
The groups did not differ significantly in the incidence of analgesia or anesthesia expected in the median nerve distribution, where there was a significantly lower incidence of anesthesia in the back of the artery group. This group also had a slower onset of anesthesia for the median and the medial antebrachial cutaneous nerves.
Conclusions:
There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.