Document Detail


A prospective, randomized comparison between single- and double-injection, ultrasound-guided supraclavicular brachial plexus block.
MedLine Citation:
PMID:  19920418     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: This prospective, randomized, observer-blinded study compared single- and double-injection, ultrasound-guided supraclavicular brachial plexus block for upper extremity surgery. METHODS: Ninety-two patients were randomly allocated to receive a single-injection (n = 46) or double-injection (n = 46), ultrasound-guided supraclavicular block. Performance time (defined as the sum of imaging and needling times) and the number of needle passes were recorded during the performance of the block. Subsequently, a blinded observer recorded the onset time, block-related pain scores, success rate (surgical anesthesia), and the incidence of complications. The total anesthesia-related time was defined as the sum of the performance and onset times. The main outcome variable was the onset time. RESULTS: The onset time was shorter with the 2-injection technique (17.5 mins [SD, 8.4 mins] vs 21.7 mins [SD, 7.2 mins]; P = 0.021); however, performance time was also longer (7.2 mins [SD, 2.7 mins] vs 6.0 mins [SD, 2.4 mins]; P = 0.037). Thus, no differences were observed in terms of total anesthesia-related time (23.4-24.3 mins). Success rates (95.7%), block-related pain scores, and complication rates were also similar between the 2 groups. As expected, the 2-injection technique required a greater number of needle passes (3.5 [SD, 1.2] vs 1.9 [SD, 1.1]; P < 0.001). In return, it provided a faster onset for sensory and motor block of the musculocutaneous nerve and a faster sensory block of the radial nerve. However, at 30 mins, no differences were observed. CONCLUSION: The double-injection, ultrasound-guided supraclavicular block provides no significant advantages compared with its single-injection counterpart.
Authors:
De Q H Tran; Loreto Mu?oz; Cedrick Zaouter; Gianluca Russo; Roderick J Finlayson
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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 Sep-Oct
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-27     Revised Date:  2010-03-18    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  420-4     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, McGill University, Montreal General Hospital, Montreal, Quebec, Canada. de_tran@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthetics, Local / administration & dosage*,  adverse effects
Brachial Plexus / drug effects*,  ultrasonography*
Drug Administration Schedule
Female
Humans
Injections
Male
Middle Aged
Motor Activity / drug effects
Nerve Block* / adverse effects
Pain, Postoperative / prevention & control
Prospective Studies
Sensory Thresholds / drug effects
Time Factors
Ultrasonography, Interventional*
Upper Extremity / surgery
Young Adult
Chemical
Reg. No./Substance:
0/Anesthetics, Local
Comments/Corrections
Comment In:
Reg Anesth Pain Med. 2010 Mar-Apr;35(2):223; author reply 223   [PMID:  20216041 ]

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


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