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Axillary brachial plexus anesthesia: electrical versus cold saline stimulation
J Rodríguez1, M Bárcena, J Alvarez
1Anesthesiology Department, Complexo Hospitalario Universitario de Santiago, Santiago University, Santiago de Compostela, Spain.
Anesthesia and Analgesia
|October 1, 1996
Summary
Cold saline-induced paresthesia and nerve stimulators equally achieved successful brachial plexus blocks. Cold saline was effective on the first attempt in 75% of patients, while nerve stimulators evoked motor responses in 85%.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Brachial plexus blocks are crucial for upper extremity surgery.
- Optimizing nerve localization techniques is essential for successful blocks.
Purpose of the Study:
- To compare the efficacy of cold saline-induced paresthesia versus a nerve stimulator for brachial plexus block success.
- To determine the preferred method for achieving a successful axillary brachial plexus block.
Main Methods:
- A randomized study involving 40 patients undergoing axillary brachial plexus block.
- Group A received cold saline (below 11°C), Group B used a nerve stimulator.
- Success was defined by Vester-Andersen criteria; blocks used mepivacaine and sodium bicarbonate.
Main Results:
- Both methods resulted in a successful block in 19 patients (95%) each.
- Cold saline induced paresthesia in 95% of patients (75% on first attempt).
- Nerve stimulator evoked motor response in 85% of patients; 10% had paresthesia without motor response.
Conclusions:
- Cold saline-induced paresthesia and nerve stimulators demonstrate comparable efficacy for axillary brachial plexus blocks.
- Cold saline offers a viable alternative for nerve localization, particularly for achieving paresthesia on initial attempts.