The aim of this study was to compare the success rate of US-guided SI and DI techniques for upper limb surgery.
PDOXUSRSNET WINDOWS 7 KEYGEN
Despite good success rates reported with these US-SCB using single or multiple injections, no consensus exists on the best technique to use. However, these studies did not demonstrate regarding the onset of block or the nerves blocked. Several studies have been done comparing different approaches for brachial plexus block and showed that multiple injection techniques tend to be more successful, resulting in a faster onset of anesthesia and higher success rates with least complications.
The US-guided corner pocket technique (SI) has been reported to have the highest success rate, but the disadvantage of this technique is that it may miss the upper part of the plexus, leading to an incomplete blockade. In a double-injection (DI) technique, half the volume is deposited at the corner pocket and the other half is injected inside the neural cluster. This is also known as the single-injection (SI) technique. Techniques for US-guided SCB consist of injecting the entire volume of LA at the intersection of the first rib and the subclavian artery (the “corner pocket” technique) or entire volume of LA at the cluster. Real-time USG improves the block quality, shortens its latency, and reduces the minimum volume required to obtain a successful nerve block. In addition, it helped to avoid complications such as intraneuronal and intravascular injection. After the advent of ultrasound (US) in regional anesthesia, it was possible to verify the accurate location of the needle tip in relation to the nerves and distribution of LA. The most important requirement for successful regional anesthetic block is exact needle position and proper delivery of the local anesthetic (LA). The supraclavicular approach to brachial plexus block (SCBPB) or the supraclavicular block (SCB) anesthetizes the brachial plexus providing a complete and reliable blockade for upper extremity surgery. The DI technique results in a faster onset and hence a shorter TART however, it may not be clinically relevant. Conclusion: The success rates in both the SI and DI techniques are comparable. The sensory and motor block achieved was comparable between both groups. There was a statistically significant lesser performance time in group SI than in group DI ( p < 0.034). The DI group had a significantly faster onset than the SI group ( p = 0.0172).
Results: The demographic data were comparable between both groups. Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Methods: After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. Background: The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures.
0 kommentar(er)
