Document Detail

The effect of motor activity on the onset and progression of brachial plexus block with bupivacaine: a randomized prospective study in patients undergoing arthroscopic shoulder surgery.
MedLine Citation:
PMID:  18227331     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A decreased latency of onset of neural blockade has been noted when muscular exercise of the hand was performed after supraclavicular brachial plexus block using lidocaine. In this observational study, we examined the effect of repetitive muscle contraction of the hand on the speed of onset of interscalene brachial plexus block (ISB) using bupivacaine. METHODS: Forty patients were enrolled, all of whom received an ISB as one component of their anesthetic management for elective arthroscopic shoulder surgery. Patients were asked either to rest their arms after the performance of the ISB (nonexercise group) or to perform a repetitive hand exercise for 5 min (exercise group). Bilateral hand grip strength and tolerance to transcutaneous electrical stimulation were used to quantify the degree of motor and sensory blockade. RESULTS: Patients in the exercise group had a statistically significant lower tolerance to transcutaneous electrical stimulation 20 min after completion of the block (P < 0.05). CONCLUSIONS: Our results imply that attempting to use a frequency-dependent conduction block with repetitive motor activity as a clinical adjuvant to brachial plexus block with bupivacaine is without merit.
Kenneth E Langen; Kenneth D Candido; Michael King; Guido Marra; Alon P Winnie
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  106     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-02-19     Revised Date:  2008-09-11    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  659-63, table of contents     Citation Subset:  AIM; IM    
Department of Anesthesiology, Loyola University Medical Center, 2160 South First Ave., Maywood, IL 60153, USA.
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MeSH Terms
Arthroscopy / methods*
Brachial Plexus / physiology*,  surgery
Middle Aged
Motor Activity / physiology*
Nerve Block / methods*
Prospective Studies
Shoulder / physiology,  surgery*
Reg. No./Substance:
Comment In:
Anesth Analg. 2008 Sep;107(3):1082-3; author reply 1083   [PMID:  18713934 ]

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

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