Faculty Opinions recommendation of Ultrasound guided axillary brachial plexus block.

2016 ◽  
Author(s):  
Jan Jakobsson
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block

scholarly journals Construct validity of a novel assessment tool for ultrasound-guided axillary brachial plexus block

Anaesthesia ◽  
2016 ◽  
Vol 71 (11) ◽  
pp. 1324-1331 ◽  
Author(s):  
O. M. A. Ahmed ◽  
B. D. O'Donnell ◽  
A. G. Gallagher ◽  
D. S. Breslin ◽  
C. M. Nix ◽  
...  
Keyword(s):  
Construct Validity ◽  
Brachial Plexus ◽  
Assessment Tool ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Axillary Brachial Plexus Block ◽  
Plexus Block

scholarly journals Effects of Clonidine as an Adjuvant to Lidocaine with Epinephrine in Ultrasound Guided Axillary Brachial Plexus Block: A Randomised Controlled Trial

2021 ◽  
Vol 10 (18) ◽  
pp. 4181
Author(s):  
Anil Ranganath ◽  
Tomas Hitka ◽  
Gabriella Iohom
Keyword(s):  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Ultrasound Guided ◽  
Axillary Brachial Plexus Block ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

This study evaluated the effects of adding adjuvant clonidine to lidocaine with epinephrine on the characteristics of ultrasound-guided axillary brachial plexus block (ABPB) for upper extremity surgery. Twenty-four patients were randomised to receive an ultrasound guided ABPB with 20 mL of lidocaine 2% with 1:200,000 epinephrine plus 2 mL of either normal saline 0.9% (Group 1) or a mixture of clonidine 1 µg/kg and normal saline 0.9% (Group 2). The outcome measures that were recorded were the overall onset time and the duration of sensory and motor block. The median (IQR) overall onset time of sensory and motor block was significantly shorter in Group 2 vs. Group 1 (5 (5–7.5) min vs. 10 (8.8–12.5) min; p < 0.001) and (5 (2.5–7.5) min vs. 7.5 (6.3–7.5) min; p = 0.001), respectively. The median (IQR) overall duration of sensory and motor block was significantly longer in Group 2 vs. Group 1 (225 (200–231) min vs. 168 (148–190) min; p < 0.001) and (225 (208–231) min vs. 168(148–186) min; p < 0.001), respectively. In ultrasound-guided ABPB, the addition of clonidine to lidocaine with epinephrine resulted in shorter onset time and prolonged duration of sensory and motor block.

scholarly journals Effects of local anaesthetic dilution on the characteristics of ultrasound guided axillary brachial plexus block: a randomised controlled study

2021 ◽  
Author(s):  
Anil Ranganath ◽  
Osman Ahmed ◽  
Gabriella Iohom
Keyword(s):  
Brachial Plexus ◽  
Local Anaesthetic ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Ultrasound Guided ◽  
Performance Time ◽  
Axillary Brachial Plexus Block ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

Aims: Ultrasound guidance has led to marked improvement in the success rate and characteristics of peripheral nerve blocks. However, effects of varying the volume or concentration of a fixed local anaesthetic dose on nerve block remains unclear. The purpose of our study was to evaluate whether at a fixed dose of lidocaine, altering the volume and concentration will have any effect on the onset time of ultrasound-guided axillary brachial plexus block.Material and methods: Twenty patients were randomised to receive an ultrasound-guided axillary brachial plexus block with either lidocaine 2% with epinephrine (20 ml, Group 2%) or lidocaine 1% with epinephrine (40 ml, Group 1%). The primary endpoint was block onset time. Secondary outcomes included duration of the block, performance time, number of needle passes, incidence of paraesthesia and vascular puncture.Results: The median [IQR] onset time of surgical anaesthesia was shorter in Group 1% when compared to Group 2% (6.25 [5-7.5] min vs 8.75 [7.5-10] min; p=0.03). The mean (SD) overall duration of surgical anaesthesia was significantly shorter in Group 1% compared to Group 2% (150.9±17.2 min vs 165.1±5.9 min; p=0.02). Group 1% had a shorter performance time with fewer needle passes. The incidence of vascular puncture and paraesthesia was similar in the two groups.Conclusion: Ultrasound-guided axillary brachial plexus blocks performed using a higher volume of lower concentration lidocaine was associated with shorter onset time and duration of surgical anaesthesia.

scholarly journals An Estimation of the Minimum Effective Anesthetic Volume of 2% Lidocaine in Ultrasound-guided Axillary Brachial Plexus Block

2009 ◽  
Vol 111 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Brian D. O’Donnell ◽  
Gabrielle Iohom
Keyword(s):  
Brachial Plexus ◽  
Local Anesthetic ◽  
Brachial Plexus Block ◽  
Hand Surgery ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Performance Time ◽  
Axillary Brachial Plexus Block ◽  
Block Success ◽  
Plexus Block

Background Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block. Methods After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve. Results The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases. Conclusion Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.

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