Document Detail

Does local anesthetic dilution influence the clinical effectiveness of multiple-injection axillary brachial plexus block?: a prospective, double-blind, randomized clinical trial in patients undergoing upper limb surgery.
MedLine Citation:
PMID:  19920416     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The relationship between the dose, volume, and concentration of local anesthetic and the quality and success of regional anesthesia remains unclear. Our aim was to test whether using 3 different volumes of the same local anesthetic dose influences the success rate of an axillary brachial plexus block with a multiple-injection technique in patients undergoing upper limb surgery. METHODS: One hundred sixty-five patients were prospectively randomized to 1 of 3 groups. Each group received an axillary block with mepivacaine 400 mg, diluted in 3 different volumes (20, 30, and 40 mL). Outcome measures recorded were the block success rate at 30 mins, sensory and motor onset times, and length of postoperative sensory and motor blockade. RESULTS: No difference was found in the rate of successful axillary plexus blocks determined when the 30-min follow-up ended among the 3 groups: 94% for 20-mL volume, 94% for 30-mL volume, and 98% for 40-mL volume. The median sensory and motor onset times of anesthesia did not differ. However, postoperative motor blockade and sensory analgesia lasted significantly longer in the patients receiving mepivacaine 400 mg diluted in a volume of 30 mL than in the other groups. CONCLUSIONS: An axillary brachial plexus block induced with a multiple-injection technique with mepivacaine 400 mg yields a high success rate regardless of the volume of anesthetic injected.
Laura Bertini; Stefano Palmisani; Stefania Mancini; Ornella Martini; Rossana Ioculano; Roberto Arcioni
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Publication Detail:
Type:  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 Sep-Oct
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  408-13     Citation Subset:  IM    
Department of Trauma Anesthesia and Pain Management, Centro Traumatologico Ortopedico-ASL RMC, La Sapienza University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy.
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MeSH Terms
Anesthetics, Local / administration & dosage*
Brachial Plexus / drug effects*
Double-Blind Method
Drug Administration Schedule
Mepivacaine / administration & dosage*
Middle Aged
Motor Activity / drug effects
Nerve Block*
Prospective Studies
Sensory Thresholds / drug effects
Time Factors
Upper Extremity / surgery*
Reg. No./Substance:
0/Anesthetics, Local; 96-88-8/Mepivacaine

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

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