Our Experience in Plexus Brachialis Block Using Ultrasonography and Nerve Stimulator

• Main Authors: Cem Kaçar, Ebru Tarıkçı Kılıç, Hakan Akelma, Ayhan Kaydu, Yakup Aksoy, Ömer Fatih Şahin, Osman Uzundere, Erhan Gökçek
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2018-06-01
• Series: Haseki Tıp Bülteni
• Subjects: Ultrasonography; upper extremity block; regional anesthesia; nerve stimulator
• Online Access: http://www.hasekidergisi.com/archives/archive-detail/article-preview/our-experience-in-plexus-brachialis-block-using-ul/18994

Aim: To compare our experiences of the brachial plexus block (BPB) using nerve stimulator (NS) and ultrasonography (US) for upper limb surgery. Methods: This retrospective study was designed in 186 American Society of Anesthesiologists I-II-III patients undergoing upper extremity surgery under BPB (supraclavicular, interscalene and infraclavicular block) by US guidance and NS. The patients were divided into two groups as US group (n=118) and NS group (n=68). Data on demographical characteristics, premedication, position, regional block approach, number of stimulator needles, dose of local anesthetics, and success rate were recorded. Results: Demographic data were similar and no statistically difference was recorded between the groups in nerve block method (interscalene, supraclavicular, infraclavicular) (p>0.05). 20 mL 0.5% bupivacaine + 10 mL 2% lidocaine were administered. Blocks were performed with a sedation regimen (1-3 mg midazolam). There was a significant difference in success rates between US (94.1%) and NS groups (80.9%) (p<0.005). Horner’s syndrome was observed in three patients in NS group (4.4%), and four patients in US group (4.2). In addition, hematoma, local anesthetic toxicity and pneumothorax were observed in 3.1 and one patients, respectively, in NS group. Conclusion: Ultrasonographic guidance improves the success of regional anesthesia and causes less complication compared to block using NS.