scholarly journals Application of Intelligent Ultrasound in Real-Time Monitoring of Postoperative Analgesic Nerve Block

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zhengwei Li ◽  
Ling Zhao ◽  
Wutao Wang ◽  
Ling Zheng
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Real Time ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Nerve Stimulator ◽  
Ultrasound Guided ◽  
Intelligent Monitoring ◽  
Average Success Rate ◽  
Plexus Block

In order to monitor the effect of nerve block in postoperative analgesia more accurately, this paper puts forward the application research of ultrasonic real-time intelligent monitoring of nerve block in postoperative analgesia. Ultrasonic real-time intelligent monitoring of nerve block in upper limb surgery, lower limb surgery, and abdominal surgery combined with the nerve stimulator. The experiments show that there are 5 cases of adverse reactions when the nerve stimulator is only used, but no adverse reactions occur when combined with ultrasound-guided block. Continuous subclavian brachial plexus block with the ultrasound-guided nerve stimulator can clearly see the subclavian brachial plexus and its surrounding tissue structure, the direction of needle insertion in the plane, and the diffusion of narcotic drugs. The average success rate of block was up to 95.2%, which was significantly higher than that of nerve stimulator alone, and the success rate of recatheterization after the first failure was also improved. The average postoperative analgesia satisfaction was 85.6%, the average operation time was only 20 min, and the subclavian artery and pleura were avoided effectively. No pneumothorax and other complications occurred. The average success rate of ultrasound-guided subclavicular brachial plexus block in 1-2-year-old children was 97%, which was much higher than the average success rate of nerve stimulator localization with 63%. Ultrasound-guided nerve block not only directly blocks nerves under visual conditions but also helps to observe the structures around nerves and dynamically observe the diffusion of local anesthetics, which can significantly improve the accuracy and success rate of nerve block and reduce the incidence of complications.

Block characteristics of Dexmedetomidine as an adjuvant to local anaesthetic in Infraclavicular brachial plexus block using peripheral nerve stimulator and ultrasound

2021 ◽  
Vol 23 (2) ◽  
pp. 40-46
Author(s):  
Ujma Shrestha ◽  
Sushila Lama Moktan ◽  
Sanjay Shrestha
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
Nerve Stimulator ◽  
Ultrasound Guided ◽  
Peripheral Nerve Stimulator ◽  
Infraclavicular Brachial Plexus Block ◽  
Plexus Block

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.

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

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.

scholarly journals Evaluation of ultrasound guided verses nerve stimulator technique of interscalene brachial plexus block: insights from Indian multi-super specialty hospital

2018 ◽  
Vol 6 (7) ◽  
pp. 2503 ◽  
Author(s):  
Kiran Kumar G. V. ◽  
Rammohan Gurram ◽  
Gajanan Fultambkar ◽  
Amit Omprakash Gupta ◽  
Onkar C. Swami
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Real Life ◽  
Nerve Stimulator ◽  
Patient Satisfaction Score ◽  
Interscalene Brachial Plexus Block ◽  
Significant Difference ◽  
Plexus Block

Background: To provide adequate intraoperative anaesthesia and postoperative analgesia for orthopaedic surgery continues to be a procedural challenge. The administration of brachial plexus anaesthesia can be facilitated through nerve stimulation or by ultrasound guidance. Hence study was conducted to compare differences in these techniques in patients undergoing interscalene brachial plexus block (ISSB).Methods: In this prospective, randomized, observer-blinded study, 60 patients (Male=41, Female=19) were scheduled for orthopaedic shoulder and upper arm surgeries matching inclusion and exclusion criteria. Patients were randomly allocated to either Ultrasound (US, n=30) group or Nerve Stimulator (NS, n=30) group through a computer-generated randomization.Results: There was significant difference between US and NS group with respect to average number of attempts taken, block performance time (BPT), onset of sensory and motor block, duration of motor block and patient satisfaction score. Whereas not much significant difference was observed in duration of sensory block, block success rate and incidence of post operative side effects.Conclusions: The results suggest that US guided ISBB is significantly superior to NS guided block in terms of faster onset of action; lower number of attempts to locate Interscalene brachial plexus; longer duration of block and overall success rate with favourable tolerability at real-life scenario.

SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES: ULTRASOUND-GUIDED VERSUS NERVE STIMULATORTECHNIQUE

2017 ◽  
pp. 104-108
Author(s):  
Van Tri Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Objective: To compare the onset and duration ofsensory and motor blockade,success and complications rate of these two techniques. Subjects and methods: One hundred and twenty patients undergoing upper limb surgeries at Hue Central Hospital from May 2016 to May 2017 were divided into two groups. Group I underwentultrasound-guided supraclavicular brachial plexus block, group II with nerve stimulator. Each group received 25ml levobupivacaine 0.5% and 1/200000 adrenalin. Results:The procedure time (9.82 ± 4.55 vs 14.73 ± 4.73 min), the onset of sensory (6.15 ± 1.60 vs 9.92 ± 2.88 min) and motor block (7.95 ± 1.05 vs 12.63 ± 2.15 min) in group I were significant shorter than in Group II (p < 0.05). The duration of sensory and motor block, (481.38 ± 116.66 vs 319.22 ± 143.14 min and 412.97 ± 107.32 vs 205.88 ± 48.96 min, respectively) were significant longer in group I than in Group II (p < 0.05). The success rate (98.3% vs 90%) and complication incidence (1.7% vs 8.4%) were comparable between two groups. Conclusion: Ultrasound guidance for supraclavicular brachial plexus blockade provided faster onset, longer duration of sensory and motor block, higher success rate with fewer complications in comparison withnerve stimulator technique Key words: brachial plexus block, ultrasound-guided

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