Document Detail

Comparison of the transarterial axillary block and the ultrasound-guided infraclavicular block for upper extremity surgery: a prospective randomized trial.
MedLine Citation:
PMID:  19574870     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: The transarterial axillary block and the ultrasound-guided infraclavicular block are both effective methods of anesthetizing the upper extremity. This study compares these methods with respect to subjective postoperative dysesthesias, block adequacy, patient comfort, and patient satisfaction. METHODS: Two hundred thirty-two patients were randomized to receive an ultrasound-guided infraclavicular block or a transarterial axillary block for upper extremity surgery. Block placement, motor and sensory testing, and block adequacy data were recorded. The subjects were contacted by a blinded research assistant at 2 and 10 days postoperatively to assess for the presence of dysesthesias and pain and to assess patient satisfaction. RESULTS: The 2 techniques were similar with respect to block performance time and adequacy of the block for surgery. There was no significant difference between the blocks in terms of postoperative dysesthesias (23.9% in the axillary group vs 17.1% in the infraclavicular group at 2 days, P = 0.216, and 11.0% vs 6.31% at 10 days, P = 0.214). None of the dysesthesias were permanent. The infraclavicular block had a lower incidence of paresthesias during placement (P = 0.035) and was associated with less pain at the block site (P = 0.010 at 2 days, P = 0.002 at 10 days). More patients were willing to undergo the infraclavicular block as a future anesthetic when compared with the axillary block (P = 0.025 at 10 days). CONCLUSIONS: There is no significant difference between the 2 techniques in terms of adequacy for surgery and subjective postoperative dysesthesias. The ultrasound-guided infraclavicular block is associated with greater patient comfort and willingness to undergo the same anesthetic when compared with the transarterial axillary block.
Tiffany R Tedore; Jacques T YaDeau; Daniel B Maalouf; Andrew J Weiland; Sarani Tong-Ngork; Barbara Wukovits; Leonardo Paroli; Michael K Urban; Victor M Zayas; Anita Wu; Michael A Gordon
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  34     ISSN:  1532-8651     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-07-03     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  361-5     Citation Subset:  IM    
Department of Anesthesiology, New York - Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA.
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MeSH Terms
Aged, 80 and over
Axillary Artery
Brachial Plexus* / ultrasonography
Chi-Square Distribution
Middle Aged
Nerve Block / adverse effects,  methods*
Paresthesia / etiology*
Patient Satisfaction*
Prospective Studies
Punctures / methods
Statistics, Nonparametric
Ultrasonography, Interventional / methods*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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