A comparison between ultrasound-guided infraclavicular block using the "double bubble" sign and neurostimulation-guided axillary block

Anesthesia and Analgesia
De Quang Hieu TranRoderick J Finlayson

Abstract

Ultrasound-guided infraclavicular block can be performed using the double bubble sign. Previously described, the double bubble sign consists superiorly of the axillary artery (in short axis) superimposed on an inferior bubble created by local anesthetic injection. In this study, we compared this new method of brachial plexus anesthesia to the traditional triple-nerve stimulation axillary block. Seventy patients were randomized to receive a single-injection, ultrasound-guided infraclavicular block using the double bubble sign or a triple-stimulation axillary block. Both methods produced similar success rates (89%-91%). However, infraclavicular blocks were associated with a shorter performance time (3.90 +/- 2.27 vs 8.03 +/- 3.92 min; P < 0.001) and lower block-related pain scores (2.70 +/- 2.02 vs 4.17 +/- 2.57 on a 0-10 scale; P = 0.01). Compared to triple-stimulation axillary block, ultrasound-guided infraclavicular block using the double bubble sign provided a similar efficacy, a shorter performance time and lower procedural pain scores.

References

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Citations

Jan 29, 2011·Der Anaesthesist·T GeiserJ Büttner
Jan 29, 2011·Regional Anesthesia and Pain Medicine·De Q H TranRoderick J Finlayson
Nov 14, 2012·Regional Anesthesia and Pain Medicine·Andrea P GonzálezDe Q H Tran
Jun 3, 2014·Anesthesiology Clinics·Francis V Salinas, Raymond S Joseph
Oct 30, 2009·Best Practice & Research. Clinical Anaesthesiology·Paul Warman, Barry Nicholls
Feb 27, 2009·Acta Anaesthesiologica Scandinavica·De Q H TranR J Finlayson
Feb 20, 2013·Acta Anaesthesiologica Scandinavica·S Flohr-MadsenØ Klaastad
Mar 17, 2010·Veterinary Anaesthesia and Analgesia·Luis CampoyAnnie L Wang
Nov 21, 2015·Journal of Clinical Monitoring and Computing·Trygve KjelstrupPer K Hol
May 20, 2015·Cirugia y cirujanos·Guadalupe Zaragoza-LemusAlejandro Espinosa-Gutiérrez
Sep 4, 2016·Brazilian Journal of Anesthesiology·Alessandro Di FilippoChiara Adembri
Sep 7, 2014·Journal of Feline Medicine and Surgery·Agustina AnsónAmalia Agut
Nov 8, 2014·Regional Anesthesia and Pain Medicine·Stephen Choi, Colin J L McCartney
Aug 30, 2013·The Cochrane Database of Systematic Reviews·Ki Jinn ChinMandeep Singh
Jun 25, 2009·Current Opinion in Anaesthesiology·Oivind KlaastadMichael S Dodgson
Feb 18, 2012·British Journal of Anaesthesia·X Jiang, J Jiang

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