Document Detail

Is ultrasound guidance superior to conventional nerve stimulation for coracoid infraclavicular brachial plexus block?
MedLine Citation:
PMID:  19574869     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: In different peripheral nerve blocks, it has been speculated that needle guidance by ultrasound improves onset time and success rate compared with the more frequently used nerve stimulation-guided technique. In the present study, we tested the hypothesis that ultrasound guidance improves onset time of coracoid infraclavicular brachial plexus block (IBPB) when compared with a nerve stimulation-guided technique. METHODS: Seventy patients scheduled for hand or forearm surgery were randomly assigned to receive coracoid IBPB using either ultrasound guidance (group U, n = 35), or nerve stimulation (group S, n = 35). Patients were assessed for sensory and motor block every 5 mins after injection of local anesthetic. Onset time, the primary end point, was defined as the time required for complete sensory and motor block. Time required to perform the block, success rate, and time to resolution of motor blockade were also recorded (secondary end points). RESULTS: Onset of complete sensory and motor blockade was similar in the 2 groups (17 mins [8 mins] in group U and 19 mins [8 mins] in group S; P = 0.321). Time required to perform the block was shorter in group U (3 mins [1 min]) as compared with group S (6 mins [2 mins]; P < 0.0001). No differences were observed in success rate (89% in group U and 91% in group S; P = 0.881) and time to resolution of motor blockade (237 mins [45 mins] in group U and 247 mins [57 mins] in group S; P = 0.418). CONCLUSIONS: The present investigation demonstrates that ultrasound guidance and nerve stimulation provide similar onset time, success rate, and duration of motor blockade for coracoid IBPB; however, ultrasound guidance reduces the time required to perform the block.
Manuel Taboada; Jaime Rodríguez; Marcos Amor; Sergi Sabaté; Julian Alvarez; Joaquín Cortés; Peter G Atanassoff
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
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:  357-60     Citation Subset:  IM    
Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Travesíada Choupana s/n, Santiago de Compostela 15706, Spain.
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MeSH Terms
Brachial Plexus
Forearm / surgery
Hand / surgery
Middle Aged
Nerve Block / methods*
Punctures / methods
Single-Blind Method
Time Factors
Transcutaneous Electric Nerve Stimulation / instrumentation*,  methods
Ultrasonography, Interventional / methods*
Wrist / surgery

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

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