Is ultrasound guidance superior to conventional nerve stimulation for coracoid infraclavicular brachial plexus block?

BACKGROUND AND OBJECTIVES: In different peripheral nerve blocks, it has been speculated that needle guidance by ultrasound improves onset time and success rate compared with the more frequently used nerve stimulation-guided technique. In the present study, we tested the hypothesis that ultrasound guidance improves onset time of coracoid infraclavicular brachial plexus block (IBPB) when compared with a nerve stimulation-guided technique.

METHODS: Seventy patients scheduled for hand or forearm surgery were randomly assigned to receive coracoid IBPB using either ultrasound guidance (group U, n = 35), or nerve stimulation (group S, n = 35). Patients were assessed for sensory and motor block every 5 mins after injection of local anesthetic. Onset time, the primary end point, was defined as the time required for complete sensory and motor block. Time required to perform the block, success rate, and time to resolution of motor blockade were also recorded (secondary end points).

RESULTS: Onset of complete sensory and motor blockade was similar in the 2 groups (17 mins [8 mins] in group U and 19 mins [8 mins] in group S; P = 0.321). Time required to perform the block was shorter in group U (3 mins [1 min]) as compared with group S (6 mins [2 mins]; P < 0.0001). No differences were observed in success rate (89% in group U and 91% in group S; P = 0.881) and time to resolution of motor blockade (237 mins [45 mins] in group U and 247 mins [57 mins] in group S; P = 0.418).

CONCLUSIONS: The present investigation demonstrates that ultrasound guidance and nerve stimulation provide similar onset time, success rate, and duration of motor blockade for coracoid IBPB; however, ultrasound guidance reduces the time required to perform the block.

Medienart:

E-Artikel

Erscheinungsjahr:

2009

Erschienen:

2009

Enthalten in:

Zur Gesamtaufnahme - volume:34

Enthalten in:

Regional anesthesia and pain medicine - 34(2009), 4 vom: 15. Juli, Seite 357-60

Sprache:

Englisch

Beteiligte Personen:

Taboada, Manuel [VerfasserIn]
Rodríguez, Jaime [VerfasserIn]
Amor, Marcos [VerfasserIn]
Sabaté, Sergi [VerfasserIn]
Alvarez, Julian [VerfasserIn]
Cortés, Joaquín [VerfasserIn]
Atanassoff, Peter G [VerfasserIn]

Links:

Volltext

Themen:

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 27.10.2009

Date Revised 09.01.2019

published: Print

Citation Status MEDLINE

doi:

10.1097/AAP.0b013e3181ac7c19

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM189740329