Our Experience in Plexus Brachialis Block Using Ultrasonography and Nerve Stimulator

Cem Kaçar, Ebru Tarıkçı Kılıç, Hakan Akelma, Ayhan Kaydu, Yakup Aksoy, Ömer Fatih Şahin, Osman Uzundere, Erhan Gökçek
2018 Haseki Tıp Bülteni  
Aim: To compare our experiences of the brachial plexus block (BPB) using nerve stimulator (NS) and ultrasonography (US) for upper limb surgery. Methods: This retrospective study was designed in 186 American Society of Anesthesiologists I-II-III patients undergoing upper extremity surgery under BPB (supraclavicular, interscalene and infraclavicular block) by US guidance and NS. The patients were divided into two groups as US group (n=118) and NS group (n=68). Data on demographical
more » ... ical characteristics, premedication, position, regional block approach, number of stimulator needles, dose of local anesthetics, and success rate were recorded. Results : Demographic data were similar and no statistically difference was recorded between the groups in nerve block method (interscalene, supraclavicular, infraclavicular) (p>0.05). 20 mL 0.5% bupivacaine + 10 mL 2% lidocaine were administered. Blocks were performed with a sedation regimen (1-3 mg midazolam). There was a significant difference in success rates between US (94.1%) and NS groups (80.9%) (p<0.005). Horner's syndrome was observed in three patients in NS group (4.4%), and four patients in US group (4.2). In addition, hematoma, local anesthetic toxicity and pneumothorax were observed in 3.1 and one patients, respectively, in NS group. Conclusion: Ultrasonographic guidance improves the success of regional anesthesia and causes less complication compared to block using NS.
doi:10.4274/haseki.39974 fatcat:23aontydrrbqtc32h2hhcq6aou