An evaluation of brachial plexus block using a nerve stimulator versus ultrasound guidance: A randomized controlled trial

Journal of Anaesthesiology, Clinical Pharmacology
Shivinder SinghAnoop Sharma

Abstract

This study was carried out to evaluate the difference in efficacy, safety, and complications of performing brachial plexus nerve blocks by using a nerve locator when compared to ultrasound (US) guidance. A total of 102 patients undergoing upper limb surgery under supraclavicular brachial plexus blocks were randomly divided into two groups, one with US and the other with nerve stimulator (NS). In Group US, "Titan" Portable US Machine, Sonosite, Inc. Kensington, UK with a 9.0 MHz probe was used to visualize the brachial plexus and 40 ml of 0.25% bupivacaine solution was deposited around the brachial plexus in a graded manner. In Group (NS), the needle was inserted 1-1.5 cm above mid-point of clavicle. Once hand or wrist motion was detected at a current intensity of less than 0.4 mA 40 ml of 0.25% bupivacaine was administered. Onset of sensory and motor block of radial, ulnar and median nerves was recorded at 5-min intervals for 30-min. Block execution time, duration of block (time to first analgesic), inadvertent vascular puncture, and neurological complications were taken as the secondary outcome variables. About 90% patients in US group and 73.1% in NS group, had successful blocks P = 0.028. The onset of block was faster in the...Continue Reading

References

Sep 1, 1978·British Journal of Anaesthesia·P la GrangeL K Pretorius
Feb 1, 1991·Anesthesia and Analgesia·S S MoorthyJ M Anagnostou
Oct 23, 2003·Anesthesia and Analgesia·Vincent W S ChanOlusegun Odukoya
Oct 23, 2003·Anesthesia and Analgesia·Stephan R WilliamsFrançois Girard
Apr 26, 2007·Anesthesia and Analgesia·Peter Marhofer, Vincent W S Chan
Apr 26, 2007·Anesthesia and Analgesia·Vincent W S ChanPatrick Shannon
Mar 14, 2009·Regional Anesthesia and Pain Medicine·Anahi PerlasReena Karkhanis
Jan 17, 2012·Current Opinion in Anaesthesiology·Zbigniew J Koscielniak-Nielsen, Jörgen B Dahl

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