Comparison of ultrasound-guided supraclavicular block according to the various volumes of local anesthetic

다국어 초록 (Multilingual Abstract)

Background: The ultrasound guidance in regional nerve blocks has recently been introduced and gaining popularity. Ultrasound-guided supraclavicular block has many advantages including the higher success rate, faster onset time, and fewer complications. The aim of this study was to examine the clinical data according to the varied volume of local anesthetics in the ultrasound-guided supraclavicular block.
Methods: One hundred twenty patients were randomized into four groups, according to the local anesthetic volume used: Group 35 (n = 30), Group 30 (n = 30), Group 25 (n = 30), and Group 20 (n = 30). Supraclavicular blocks were performed with 1% mepivacaine 35 ml, 30 ml, 25 ml, and 20 ml, respectively. The success rate, onset time, and complications were checked and evaluated.
Results: The success rate (66.7%) was lower in Group 20 than that of Group 35 (96.7%) (P < 0.05). The average onset times of Group 35, Group 30, Group 25, and Group 20 were 14.3 ± 6.9 min, 13.6 ± 4.5 min, 16.7 ± 4.6 min, and 16.5 ± 3.7 min, respectively. There were no significant differences. Horner's syndrome was higher in Group 35 (P < 0.05).
Conclusions: In conclusion, we achieved 90% success rate with 30 ml of 1% mepivacaine. Therefore, we suggest 30 ml of local anesthetic volume for ultrasound-guided supraclavicular block.

참고문헌 (Reference)

1 Perlas A, "Ultrasoundguided supraclavicular block: outcome of 510 consecutive cases" 34 : 171-176, 2009

2 Stone MB, "Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies" 26 : 706-710, 2008

3 Kapral S, "Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus" 78 : 507-513, 1994

4 O'Donnell BD, "Ultrasound-guided axillary brachial plexus block with 20 milliliters local anesthetic mixture versus general anesthesia for upper limb trauma surgery: an observer-blinded, prospective, randomized, controlled trial" 109 : 279-283, 2009

5 McNaught A, "Ultrasound reduces the minimum effective local anesthetic volume compared with peripheral nerve stimulation for interscalene block" 106 : 124-130, 2011

6 Kuruba SM, "Ultrasound reduces the minimum effective local anaesthetic volume" 106 : 600-601, 2011

7 Sites BD, "Ultrasound guidance improves the success rate of a perivascular axillary plexus block" 50 : 678-684, 2006

8 Orebaugh SL, "The up-down methodology and practical peripheral nerve blockade" 35 : 480-481, 2010

9 Cornish PB, "The sheath of the brachial plexus: fact or fiction?" 105 : 563-565, 2006

10 Cornish PB, "The "axillary tunnel": an anatomic reappraisal of the limits and dynamics of spread during brachial plexus blockade" 104 : 1288-1291, 2007

11 Jankovic D, "Regional Nerve Blocks" Blackwell Science 67-70, 2001

12 Harper GK, "Minimum volume of local anaesthetic required to surround each of the constituent nerves of the axillary brachial plexus, using ultrasound guidance: a pilot study" 104 : 633-636, 2010

13 Duggan E, "Minimum effective volume of local anesthetic for ultrasoundguided supraclvicular brachial plexus block" 34 : 215-218, 2009

14 Tran de QH, "Minimum effective volume of lidocaine for ultrasoundguided supraclavicular block" 36 : 466-469, 2011

15 Wedel DJ, "Miller's Anesthesia" Churchill Living Stone 1640-, 2010

16 전대근, "Comparison of a supraclavicular block showing upper arm twitching response with a supraclavicular block showing wrist or finger twitching response" 대한마취통증의학회 58 (58): 464-467, 2010

17 Morgan GE, "Clinical Anesthesiology" Lange Medical Books/McGraw-Hill Medical Publishing Division 332-, 2006