Stimulation of the posterior cord predicts successful infraclavicular block

Anesthesia and Analgesia
Harish LecamwasamCarl Rosow

Abstract

Infraclavicular (IC) block is often performed by localizing one cord within the brachial plexus sheath and placing all the local anesthetic solution at that location. We hypothesized that posterior cord stimulation would be associated with a greater likelihood of IC block success. We enrolled 369 patients scheduled for surgery to the lower arm or hand in a prospective, nonrandomized observational trial. All underwent IC blocks using a standard technique, and the cord stimulated immediately before drug injection was recorded. Motor and sensory functioning were evaluated 15 min after injection. Compared with stimulation of either the lateral or medial cord, stimulation of the posterior cord was associated with rapid onset of motor block in significantly more nerves, as well as a decreased likelihood of block failure (motor and sensory block inadequate to perform surgery). Failure rates were 5.8% for posterior cord, 28.3% for lateral (P < 0.05), and 15.4% for medial (P < 0.05). The differences were highly significant when adjusted for multiple possible confounders, such as gender, body mass index, location of the incision, and level of training of the individual performing the block (P < 0.001, lateral versus posterior; P = 0.003,...Continue Reading

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Citations

Dec 7, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Maki MorimotoAndrew D Rosenberg
May 3, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Simon LévesqueMarie-Christine Desgagné
Aug 2, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Quang Hieu De TranRoderick J Finlayson
Sep 27, 2007·Der Anaesthesist·J BirnbaumT Volk
Jan 8, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·José AguirreAlain Borgeat
Mar 14, 2009·Regional Anesthesia and Pain Medicine·Joseph M NealQuinn H Hogan
Jul 10, 2009·Regional Anesthesia and Pain Medicine·Nizar MoayeriGerbrand J Groen
Jul 4, 2009·Regional Anesthesia and Pain Medicine·Manuel TaboadaPeter G Atanassoff
Aug 26, 2009·Anesthesiology Clinics·Arjunan Ganesh, Harshad G Gurnaney
Jun 19, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·S BlocG Dhonneur
Aug 18, 2009·Acta Anaesthesiologica Scandinavica·E AkyildizK Toker
Feb 27, 2009·Acta Anaesthesiologica Scandinavica·De Q H TranR J Finlayson
Jul 5, 2012·Anesthesiology Research and Practice·José AguirreStephan Blumenthal
Sep 9, 2009·Acta Anaesthesiologica Scandinavica·J RodríguezJ Alvarez
May 20, 2015·Cirugia y cirujanos·Guadalupe Zaragoza-LemusAlejandro Espinosa-Gutiérrez
Aug 8, 2012·Korean journal of anesthesiology·Chun Woo YangChul Woung Kim
Jan 24, 2007·Anesthesia and Analgesia·Vincent MinvilleHervé Bouaziz
Jan 10, 2012·International Anesthesiology Clinics·Joni M MagaRalf E Gebhard
Mar 5, 2009·Regional Anesthesia and Pain Medicine·Jyotsna PunjRavinder Pandey

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