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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
PubMed
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%.

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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.

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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.