Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial.
机构:[1]Department of Anesthesiology, Guangdong Second Provincial People’s Hospital[2]Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China中山大学附属第三医院[3]Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine
To evaluate the efficacy of a nerve stimulator when used with ultrasound-guided double injection in supraclavicular brachial plexus block.
We hypothesised that targeting the inferior trunk of the plexus guided by a nerve stimulator would obtain a higher success rate of ulnar nerve blockade than the traditional double-injection technique.
A blinded randomised controlled study.
Conducted at the University Hospital from October 2015 to January 2016.
Ninety patients undergoing upper extremity surgery were randomised into two equal groups.
Patients were randomly allocated to a modified double-injection group (MDI group) or a traditional double-injection group (DI group). All patients received 23 ml of a 1 : 1 mixture of 2% lidocaine and 1% ropivacaine during ultrasound-guided supraclavicular brachial plexus block. In the MDI group (n = 45), half the volume was deposited within the brachial plexus sheath guided by ultrasound, next to the inferior trunk and verified by nerve stimulation; the remaining volume was deposited in the main neural cluster. In the double-injection group (n = 45), the first half volume was deposited on ultrasound guidance alone. Sensory-motor blockade of the musculocutaneous, median, radial, ulnar nerves and surgical anaesthesia, performance time, number of needle passes and complications were recorded.
The success rate of complete sensory block of the ulnar nerve within 15 min after local anaesthetic injection.
Compared with the DI group the MDI group had higher success rates of complete sensory block of the ulnar nerve (93 vs 67%, P = 0.002) and complete anaesthesia (80 vs 56%, P = 0.014) at 15 min, whereas the average performance time was significantly longer (5.08 ± 1.41 vs 4.10 ± 0.64 min, P < 0.001) and the number of needle passes was significantly higher (4.40 ± 1.14 vs 2.87 ± 0.79, P < 0.001).
The MDI technique has a higher success rate for complete sensory block of the ulnar nerve within 15 min of local anaesthetic injection. The time needed to perform the block is about 1 min longer than the traditional technique.
http://www.chictr.org.cn with the registration number of ChiCTR-IOR-15007588.
基金:
this work was supported by
Department of Anesthesiology, the First Affiliated Hospital of
Guangzhou University of Chinese Medicine, Guangzhou, China.
第一作者机构:[1]Department of Anesthesiology, Guangdong Second Provincial People’s Hospital[3]Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine
通讯作者:
通讯机构:[1]Department of Anesthesiology, Guangdong Second Provincial People’s Hospital[*1]Department of Anesthesiology, Guangdong Second Provincial People’s Hosipital, 466# XingangMiddle Road, Guangzhou, 510317, China
推荐引用方式(GB/T 7714):
Quehua Luo,Weifeng Yao,HaiHua Shu,et al.Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial.[J].EUROPEAN JOURNAL OF ANAESTHESIOLOGY.2017,34(3):127-134.doi:10.1097/EJA.0000000000000542.
APA:
Quehua Luo,Weifeng Yao,HaiHua Shu&Ming Zhong.(2017).Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial..EUROPEAN JOURNAL OF ANAESTHESIOLOGY,34,(3)
MLA:
Quehua Luo,et al."Double-injection technique assisted by a nerve stimulator for ultrasound-guided supraclavicular brachial plexus block results in better distal sensory-motor block: A randomised controlled trial.".EUROPEAN JOURNAL OF ANAESTHESIOLOGY 34..3(2017):127-134