PDF(Pubmed)
Abstract：
BACKGROUND: Regional anaesthesia offers the anaesthesiologist, the surgeon, as well as the patient advantages over general anaesthesia such as being conscious through the surgery, avoiding multiple drugs, better haemodynamic stability, excellent postoperative analgesia, and faster per oral consumption post surgery. Compared with the axillary approach, the brachial plexus block at the level of the clavicle can anaesthetize all four distal upper extremity nerve territories without the requirement for a separate block of the musculocutaneous nerve.
OBJECTIVE: The aim of the study was to compare the effect of both supraclavicular and infraclavicular brachial plexus blocks in terms of time taken for onset, performance, and block success.
METHODS: Sixty patients undergoing below-elbow upper limb surgeries were randomized into two groups: (i) supraclavicular (Group S) and (ii) infraclavicular (Group I). All patients received 30ml 0f 0.5% bupivacaine as the local anesthetic of choice. The block performance time, time taken for onset of sensory and motor blockade, total duration of block, and hemodynamic parameters were observed. The block performance times and the onset of the sensory blockade were the primary outcomes while the duration of the block and hemodynamic parameters were secondary outcomes. Two two-tailed independent sample t-tests will be used to compare the variables.
RESULTS: We observed that the block performance time for the infraclavicular block (mean 14.833 minutes) was longer than the supraclavicular block (mean 10.37 minutes). This was statistically significant with p <0.001. In terms of onset of sensory blockade, the infraclavicular group (13.667 minutes) had a quicker onset compared to the supraclavicular group (17.333 minutes). This was also statistically significant with p <0.001. The mean total duration of sensory and motor blockade was similar in both groups (p-value of 0.341 and 0.791 respectively) and there was no statistical difference. There was no hemodynamic instability or complications in our study.
CONCLUSIONS: Ultrasound-guided infraclavicular block is a relatively safer technique when compared to the supraclavicular technique with faster onset. The time taken for administering the infraclavicular block can be reduced by repeated exposure to the technique.
OBJECTIVE: The aim of the study was to compare the effect of both supraclavicular and infraclavicular brachial plexus blocks in terms of time taken for onset, performance, and block success.
METHODS: Sixty patients undergoing below-elbow upper limb surgeries were randomized into two groups: (i) supraclavicular (Group S) and (ii) infraclavicular (Group I). All patients received 30ml 0f 0.5% bupivacaine as the local anesthetic of choice. The block performance time, time taken for onset of sensory and motor blockade, total duration of block, and hemodynamic parameters were observed. The block performance times and the onset of the sensory blockade were the primary outcomes while the duration of the block and hemodynamic parameters were secondary outcomes. Two two-tailed independent sample t-tests will be used to compare the variables.
RESULTS: We observed that the block performance time for the infraclavicular block (mean 14.833 minutes) was longer than the supraclavicular block (mean 10.37 minutes). This was statistically significant with p <0.001. In terms of onset of sensory blockade, the infraclavicular group (13.667 minutes) had a quicker onset compared to the supraclavicular group (17.333 minutes). This was also statistically significant with p <0.001. The mean total duration of sensory and motor blockade was similar in both groups (p-value of 0.341 and 0.791 respectively) and there was no statistical difference. There was no hemodynamic instability or complications in our study.
CONCLUSIONS: Ultrasound-guided infraclavicular block is a relatively safer technique when compared to the supraclavicular technique with faster onset. The time taken for administering the infraclavicular block can be reduced by repeated exposure to the technique.
摘要：
背景：区域麻醉为麻醉师提供了，外科医生,以及患者相对于全身麻醉的优势，例如通过手术有意识，避免多种药物，更好的血流动力学稳定性，出色的术后镇痛，手术后每次口服消耗更快。与腋路相比，锁骨水平的臂丛神经阻滞可以麻醉所有四个上肢远端神经区域，而无需单独阻滞肌皮神经。
目的：本研究的目的是比较锁骨上和锁骨下臂丛神经阻滞在起效时间上的效果，性能，阻止成功。
方法：将60例接受肘下上肢手术的患者随机分为两组：（i）锁骨上（S组）和（ii）锁骨下（I组）。所有患者均接受30ml0f0.5％布比卡因作为局部麻醉药。块性能时间，感觉和运动阻滞发作所需的时间，块的总持续时间，并观察血流动力学参数。阻滞执行时间和感觉阻滞的开始是主要结果，而阻滞持续时间和血液动力学参数是次要结果。将使用两个双尾独立样本t检验来比较变量。
结果：我们观察到锁骨下阻滞的阻滞表现时间（平均14.833分钟）长于锁骨上阻滞（平均10.37分钟）。这是统计学上显著的,p<0.001。就感觉阻滞的发作而言，与锁骨上组(17.333分钟)相比,锁骨下组(13.667分钟)起效更快.这也是统计学上显著的,p<0.001。两组感觉和运动阻滞的平均总持续时间相似（p值分别为0.341和0.791），没有统计学差异。在我们的研究中没有血流动力学不稳定或并发症。
结论：与起效更快的锁骨上技术相比，超声引导锁骨下阻滞是一种相对更安全的技术。通过反复暴露于该技术可以减少施用锁骨下阻滞所需的时间。
目的：本研究的目的是比较锁骨上和锁骨下臂丛神经阻滞在起效时间上的效果，性能，阻止成功。
方法：将60例接受肘下上肢手术的患者随机分为两组：（i）锁骨上（S组）和（ii）锁骨下（I组）。所有患者均接受30ml0f0.5％布比卡因作为局部麻醉药。块性能时间，感觉和运动阻滞发作所需的时间，块的总持续时间，并观察血流动力学参数。阻滞执行时间和感觉阻滞的开始是主要结果，而阻滞持续时间和血液动力学参数是次要结果。将使用两个双尾独立样本t检验来比较变量。
结果：我们观察到锁骨下阻滞的阻滞表现时间（平均14.833分钟）长于锁骨上阻滞（平均10.37分钟）。这是统计学上显著的,p<0.001。就感觉阻滞的发作而言，与锁骨上组(17.333分钟)相比,锁骨下组(13.667分钟)起效更快.这也是统计学上显著的,p<0.001。两组感觉和运动阻滞的平均总持续时间相似（p值分别为0.341和0.791），没有统计学差异。在我们的研究中没有血流动力学不稳定或并发症。
结论：与起效更快的锁骨上技术相比，超声引导锁骨下阻滞是一种相对更安全的技术。通过反复暴露于该技术可以减少施用锁骨下阻滞所需的时间。
