CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Koscielniak-Nielsen, Z. J.
Right arrow Articles by Stenor, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Koscielniak-Nielsen, Z. J.
Right arrow Articles by Stenor, M.

Canadian Journal of Anesthesia, Vol 46, 658-664, Copyright © 1999 by Canadian Anesthesiologists' Society

ARTICLES

Low dose axillary block by targeted injections of the terminal nerves

ZJ Koscielniak-Nielsen, P Rotboll Nielsen, T Sorensen and M Stenor
Department of Anaesthesia and Intensive Care, National University Hospital, Rigshospitalet AN 4132, Copenhagen, Denmark. zjkn@rh.dk

PURPOSE: To compare anesthetic time, success rate and adverse effects of axillary block by single or multiple injections of local anesthetic. METHODS: Two groups of patients were studied. In group T (targeted injections, n = 53) the four terminal nerves were located by electrical stimulation, and anesthetized with 5 ml mepivacaine 1% with epinephrine 5 microg x ml(-1) (MEPE). In group S (single injection, n = 53) 80 mL MEPE 1% were injected into the neurovascular sheath, transarterially or after eliciting paresthesia. Patchy blocks were supplemented after 30 min. The patient was ready for surgery when analgesia was present in all areas distal to the elbow. RESULTS: The block was complete at 11 min (6-15) in Group T and 7 min (5-13) in group S, P<0.01. Supplementation was required in 46% in group S compared with 13% in group T P<0.001: anesthesia time was 32 min (19-52) in group T, and 39 min (16-58) in group S, P = 0.02. The average doses of MEPE were 3.5 mg x kg(-1) (2.4-5.6) in T group and 12.0 mg x kg(-1) (8.9-16.4), in S group. However, 22% of patients in group T and 4% in group S reported tourniquet pain, P = 0.02. Paresthesia was elicited in 42% of patients in group S and 8% in group T, P<0.001. CONCLUSIONS: Small targeted injections of MEPE reduce total anesthetic time, give better spread of analgesia in the hand and forearm, and may be safer than a single large injection.


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
A. Serradell, R. Herrero, J. A. Villanueva, J. A. Santos, J. M. Moncho, and J. Masdeu
Comparison of three different volumes of mepivacaine in axillary plexus block using multiple nerve stimulation{dagger}
Br. J. Anaesth., October 1, 2003; 91(4): 519 - 524.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
M. M. Coleman, F. Day, and Z. Koscielniak-Nielsen
Axillary blockade by the targeted method. Added benefit?
Can J Anesth, February 1, 2000; 47(2): 192 - 193.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1999 by the Canadian Anesthesiologists' Society.