INTERSCALENE BRACHIAL PLEXUS BLOCK WITH A NERVE STIMULATOR FOR CLAVICULAR FRACTURE SURGERY

2014 ◽  
pp. 20-24
Author(s):  
Van Minh Nguyen

Objective:To evaluate the effectiveness and side effects, complications of interscalene brachial plexus block with a nerve stimulator for clavicular fracture surgery. Materials and Methods:In a prospective descriptive study, fifty patients received interscalene brachial plexus block for fixation of clavicle fracture. The dose was 7 mg/kg of 1% lidocaine mixed with 1 : 200000 adrenaline. Results:The success rate was 94%, including 4% of patients needed sedation and small amount of narcotic, failure rate was 6%. The minimal stimulating current of the nerve location was 0.46 ±0.08 mA, the onset time of sensory block was 8.86 ±2.65min. There were 3 complications with one Horner’s syndrome and two hoarsenesses. Conclusion:We found that in patients undergoing fixation of clavicle fracture the interscalene block with a nerve stimulator was an effective anesthetic with a low rate of side effects and complications. Key words:Interscalene block, nerve stimulator, clavicular fracture surgery.

2017 ◽  
pp. 113-118
Author(s):  
Van Minh Nguyen ◽  
Thi Minh Thu Pham

Objective: To evaluate the effectiveness, side effects and complications of supraclavicular brachial plexus block with a nerve stimulator for forearm surgery. Materials and Method: In a prospective descriptive study, forty patients received supraclavicular brachial plexus block for forearm surgery. The dose was 7 mg/kg of 1% lidocaine mixed with adrenaline 1:200000. Success of technique, procedure time, onset time, duration of action, minimum current, side effects and complication were recorded. Results: The success rate was 85% (including 17.5% of patients needed small amount of fentanyl or/and local anesthetic), failure rate was 15%. The procedure time 7.70 ± 5.75 min, onset time 7.62 ± 5.09 min, duration time 172.94 ± 74.85 min. The minimal stimulating current of the nerve location was 0.54 0.12 mA. There were 2.5% with hoarseness of voice and 7.5% with blood vessel puncture. Conclusion: Supraclavicular brachial plexus block with a nerve stimulator for forearm surgery was an effective anesthetic technique with a low rate of side effects and complications. Key words: supraclavicular brachial plexus block, nerve stimulator


2021 ◽  
pp. 138-142
Author(s):  
Deba Gopal Pathak ◽  
Dipanjali Nath

BACKGROUND : Supraclavicular approach to brachial plexus block is a versatile and reliable regional anesthesia technique and a suitable alternative to general anesthesia for upper limb surgical procedures. Ropivacaine , a long acting local anesthetic, with less tendency for neurotoxicity and cardiotoxicity is a great local anesthetic for the procedure. Use of adjuvant Dexmedetomidine , a potent alpha 2 adrenoreceptor agonist improves the quality of anesthesia as well as intra-operative and post-operative analgesia while maintaining haemodynamic stability, arousable sedation and mild respiratory depression. MATERIALS AND METHODS: Eighty patients aged between 18 and 60 years with ASA grade I or II posted for elective upper limb surgeries were included in the study and were randomly divided into 2 groups with forty patients in each. Group A received 0.5% ropivacaine (31 mL) and Group B received 0.5% ropivacaine + dexmedetomidine 1microgram/kg (31mL). Both groups were compared for onset time and duration of sensory blockade, onset time and duration of motor blockade , total duration of analgesia and associated side effects. CONCLUSION : Dexmedetomidine as an adjuvant to ropivacaine in the supraclavicular brachial plexus block for upper limb surgeries , significantly shortens the onset time and prolongs the duration of sensory and motor blocks, with longer duration of post-operative analgesia , with associated significant sedation and a few manageable side effects like bradycardia and hypotension.


2020 ◽  
Vol 22 (4) ◽  
pp. 248-253
Author(s):  
Sulav Acharya ◽  
GR Bajracharya ◽  
S Gauchan ◽  
N Dhakal

Brachial plexus block is a suitable alternative to general anaesthesia for patient undergoing upper extremity surgery. Ropivacaine the S-enantiomer emerged as a possible replacement of Bupivacaine without undesirable toxic effects.Therefore this study was conducted to assess the block characteristics and side effects of 0.75% ropivacaine in axillary brachial plexus block for forearm surgeries. This interventional study was carried out in 30 patients of ASA physical status I or II, aged 18 to 60 yrs undergoing elective surgery u nder axillary brachial plexus block with 20 ml of 0.75 % Ropivacaine using ultrasound and nerve stimulator. The mean onset time of sensory block was 4.53 ± 1.18 minutes and duration of sensory block was 491.00 ± 57.45 minutes. The mean onset time of motor block was 9.17 ± 1.39 minutes and duration of motor block was 452.50 ± 52.34 minutes. The mean time for rescue analgesia or total analgesic effect was 569.47 ± 88.46 minutes. No patients developed any side effects. The result of this study concluded that Ropivacaine is a safe drug providing longer duration of sensory analgesic effect and early recovery of motor function with good operating conditions for forearm surgeries under brachial blexus block.


Author(s):  
Kiran Kumar G. V. ◽  
Rammohan Gurram ◽  
Gajanan Fultambkar ◽  
Amit Omprakash Gupta ◽  
Onkar C. Swami

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.


2002 ◽  
Vol 30 (4) ◽  
pp. 495-498 ◽  
Author(s):  
D. Sreevastava ◽  
A. Trikha ◽  
L. Sehgal ◽  
M. K. Arora

A five-year-old child with severe arthrogryposis multiplex congenita and malnutrition underwent surgery for chronic osteomyelitis of the head of the left humerus. The child had typical features of arthrogryposis multiplex congenita, including a difficult airway. Propofol was used for induction and maintenance. Spontaneous respiration was maintained with a nasal airway. Analgesia was provided with an interscalene brachial plexus block placed using a nerve stimulator. No opioid was given. The child had an uneventful recovery with good postoperative analgesia. The anaesthetic implications of arthrogryposis multiplex congenita are discussed.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Magnus Olofsson ◽  
Patrick Taffé ◽  
Kyle Robert Kirkham ◽  
Frédéric Vauclair ◽  
Bénédict Morin ◽  
...  

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