Four-Injection Brachial Plexus Block Using Peripheral Nerve Stimulator: A Comparison Between Axillary and Humeral Approaches

Introduction: Dexmedetomidine has been frequently used in regional anaesthesia to improve the quality of blocks. Addition of dexmedetomidine to local anaesthetics has been shown to hasten the onset of both sensory and motor blocks and also prolong the duration of analgesia. The objective of this prospective comparative study was to assess the change in characteristics of infraclavicular brachial plexus block after adding Inj. Dexmedetomidine to 2% Lignocaine with Adrenaline. Methods: Sixty-six patients, scheduled for upper limb surgeries under ultrasound guided infraclavicular brachial plexus block were randomly allocated to two groups. Group LS received Inj. Lignocaine 2% with Adrenaline, 7mg/kg diluted to 30 ml with saline and Group LD received Inj. Dexmedetomidine 0.75 mcg/kg in addition to Inj. Lignocaine 2% with Adrenaline, 7mg/kg again diluted to a total volume of 30 ml. The parameters studied were: onset of sensory and motor blocks and duration of analgesia. Results: Sixty patients completed the study. The demographic variables and motor block were similar between both groups. The mean time to onset of sensory block was significantly faster in Group LD compared to Group LS (9.80±4.85 min vs 12.30±3.97 min, p=0.033). The duration of analgesia was also found to be prolonged in Group LD compared to Group LS (286.73±55.38 min vs 226.53±41.19 min, p < 0.001). Conclusion: Addition of 0.75 mcg/kg of Dexmedetomidine to 2% Lignocaine with Adrenaline hastens the onset of sensory block and prolongs the duration of analgesia in ultrasound guided and peripheral nerve stimulator guided infraclavicular block.

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Incidence of hemidiaphragmatic paresis after peripheral nerve stimulator versus ultrasound guided interscalene brachial plexus block

Journal of Anaesthesiology Clinical Pharmacology ◽

10.4103/0970-9185.168263 ◽

2016 ◽

Vol 32 (2) ◽

pp. 177 ◽

Cited By ~ 7

Author(s):

PoonamSachin Ghodki ◽

NoopurDasmit Singh

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Brachial Plexus Block ◽

Nerve Stimulator ◽

Ultrasound Guided ◽

Peripheral Nerve Stimulator ◽

Interscalene Brachial Plexus Block ◽

Plexus Block

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Comparison of “standard” versus “lower” approach interscalene brachial plexus block for upper extremity surgery using peripheral nerve stimulator

MedPulse International Journal of Anesthesology ◽

10.26611/10151738 ◽

2020 ◽

Vol 17 (3) ◽

pp. 132-136

Author(s):

Rashmika Khatri ◽

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Upper Extremity ◽

Brachial Plexus Block ◽

Nerve Stimulator ◽

Peripheral Nerve Stimulator ◽

Interscalene Brachial Plexus Block ◽

Plexus Block

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Axillary brachial plexus block using peripheral nerve stimulator: A comparison between double- and triple-injection techniques

Regional Anesthesia and Pain Medicine ◽

10.1053/rapm.2001.25896 ◽

2001 ◽

Vol 26 (6) ◽

pp. 499-503 ◽

Cited By ~ 8

Author(s):

S Sia

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Brachial Plexus Block ◽

Nerve Stimulator ◽

Peripheral Nerve Stimulator ◽

Axillary Brachial Plexus Block ◽

Injection Techniques ◽

Plexus Block

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Peripheral Nerve Stimulator (PNS) Versus Trans-Arterial (TA) Techniques for Axillary Brachial Plexus Block

Galore International Journal of Health Sciences and Research ◽

10.52403/gijhsr.20210104 ◽

2021 ◽

Vol 6 (1) ◽

pp. 21-26

Author(s):

Sunil Kumar Sah ◽

Tofazzel Haque Sahana ◽

Sekhar Ranjan Basu

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Success Rate ◽

Brachial Plexus Block ◽

Randomized Study ◽

Nerve Stimulator ◽

Peripheral Nerve Stimulator ◽

Axillary Brachial Plexus Block ◽

Significant Difference ◽

Plexus Block

Background: Axillary brachial plexus block is one of the widely used techniques for upper extremity surgery. Peripheral nerve blocks (PNB) provide optimal surgical conditions while providing prolonged post-operative analgesia. The transarterial (TA) technique of axillary brachial plexus block is a well established method of producing regional anaesthesia for surgeries at or below elbow. In this prospective randomized study we compared, “peripheral nerve stimulator (PNS) versus trans-arterial (TA) techniques for axillary brachial plexus block” Methods: In this prospective, randomized study 80 patients, age>18 year, ASA-I & II, were divided randomly into two groups PNS and TA. In PNS groups 40 patients received axillary approach of brachial plexus block with the help of peripheral nerve stimulator, and rest TA group received axillary block through transarterial approach. Local anaesthetic 0.25% bupivacaine 15ml+1% lignocaine with adrenaline (1:200,000) 20 ml was used. Then success rate of two different methods of block were compared. Other parameters of comparison was block performance time of block, onset of sensory and motor block, failure rate, analgesia required etcetera. Results: The success rate of the block in PNS group was 90% and the success rate of TA group was 85% and there was no significant difference in success rate. Performance time was significantly low in trans-arterial axillary approach of brachial plexus block (p<0.005). There was no significant difference in onset of motor and sensory block. The sensory and motor functions returned properly in all patients. Conclusion: In our study we found that the PNS guided axillary block and TA injection axillary brachial plexus block provide similar success rate, and onset of block when musculocutaneous nerve blocked separately in the both techniques. Keywords: Axillary brachial plexus block, Trans-arterial approach, Peripheral nerve stimulator.

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