1% mepivacaine and axillary block: duration of the sensory and motor blockade

Abstract

To assess the duration of both sensory and motor blockade of brachial plexus with 40 mL 1% mepivacaine after axillary or midhumeral approach. Prospective, open, non-comparative, multicentric study. One hundred and eighty patients, ASA physical class 1 and 2, scheduled for hand or forearm surgery under brachial plexus block were included. A midhumeral or axillary brachial plexus block using a nerve stimulator was performed with 40 mL of 1% mepivacaine. Sensory blockade was tested for each cutaneous area (median, radial, ulnar, musculocutaneous and medial cutaneous nerve of the forearm) using pin-prick. Motor blockade was assessed by grip strength of the hand. Incidence and duration of analgesia, anaesthesia and motor blockade were assessed. The incidence of tourniquet pain and the time when pain occurred were determined. According to the nerve area tested, analgesia and anaesthesia were obtained in 98% and 85% of cases respectively; duration of anaesthesia was between 150 +/- 40 to 167 +/- 49 minutes and duration of analgesia was from 184 +/- 50 to 205 +/- 51 minutes. Duration of paralysis was 144 +/- 40 minutes and duration of paresis was 190 +/- 51 minutes. Pain occurred in three out of 138 patients at tourniquet inflation and in six patients after completion of surgery. Mid humeral or axillary block with 40 mL of 1% mepivacaine is highly successful and provides efficient surgical anaesthesia for various surgical procedures of intermediary duration.