PDF(Pubmed)
Abstract：
Background This study investigated the success rate of ultrasonography (USG)-guided supraclavicular block using a single-point injection technique comparing it with multiple-point injection technique, in terms of nerve sparing, time taken to perform the procedure, time taken to onset of sensory and motor block. Materials and methods A total of 204 patients of American Society of Anesthesiologists (ASA) Status I and II, aged 18-60 years, with body mass index (BMI) ≤30 kg/m2, posted for upper limb surgeries were given USG-guided supraclavicular brachial plexus block with 15 mL of 0.5% Ropivacaine. The patients were randomly divided into group A (single-point injection) and group B (multiple-point injection), using an out-of-plane technique. Sensory and motor block was assessed for onset and maximum grade achieved, by using pinprick, cold, touch, and movement respectively. The efficacy of the block was tested by assessment in the territories of musculocutaneous, ulnar, radial, median, axillary, and intercostobrachial nerves. Procedural time was calculated from the insertion of the needle till the complete injection of the drug. Results Patients in both groups were comparable in terms of demography and ASA status. The success rate for group A was 60.8%, compared to 98% in group B. In group B, the intercostobrachial nerve was most commonly spared (7.84%), followed by ulnar (1.96%), and radial (0.98%). On the other hand, in group A, the most frequently spared nerves were ulnar and intercostobrachial (23.5% each), followed by radial (12.7%), axillary (10.8%), musculocutaneous (7.8%), and median nerves (6.9%). The onset of sensory and motor block was similar in both groups. The procedure time was longer in the multiple-point group. Conclusion Our observations suggest that nerve sparing is much lesser in the multiple-point injection technique used for USG-guided supraclavicular block. In a good number of patients using this technique, the intercostobrachial nerve gets blocked.
摘要：
背景这项研究调查了使用单点注射技术的超声（USG）引导锁骨上阻滞的成功率，将其与多点注射技术进行比较。在保留神经方面，执行该程序所需的时间，感觉和运动阻滞发作所需的时间。材料与方法共204例美国麻醉医师学会(ASA)状态I和II,18-60岁,在体重指数（BMI）≤30kg/m2的情况下，上肢手术给予USG引导的锁骨上臂丛神经阻滞和15mL的0.5％罗哌卡因。将患者随机分为A组(单点注射)和B组(多点注射),使用平面外技术。评估感觉和运动阻滞的发作和达到的最大等级，通过使用针刺，冷,触摸,和运动分别。通过评估肌肉皮肤区域来测试阻滞的功效，尺骨,径向,中位数，腋窝,和肋间臂神经.从插入针头直到药物完全注射计算程序时间。结果两组患者在人口统计学和ASA状态方面具有可比性。A组成功率为60.8%,与B组的98%相比，B组，肋间臂神经最常幸免（7.84%），其次是尺骨(1.96%)，和径向（0.98%）。另一方面,A组,最常见的备用神经是尺骨和肋间臂（各占23.5%），其次是径向（12.7%），腋窝（10.8%），肌皮（7.8%），和正中神经(6.9%)。两组感觉和运动阻滞的发作相似。多点组的手术时间更长。结论我们的观察结果表明，在用于USG引导的锁骨上阻滞的多点注射技术中，神经保留要少得多。在大量使用这种技术的患者中，肋间臂神经被阻塞.
