Abstract
Peripheral nerve blocks with the use of ultrasonography (USG) allow visualisation of both the structures and nerves and make the block administrations safe, quick, and comfortable. However, few publications concerning the minimum local anesthetic (LA) volume are capable of providing blocks. This study aimed to find the minimum effective LA volume in brachial plexus blockage administrations with an axillary approach accompanied by ultrasonography in hand, elbow, and forehand operations.Materials and MethodThe study included a total of 55 patients (classified as American Society of Anesthesiologists (ASA) I-II) who underwent hand surgery by administering USG-guided axillary brachial plexus blockage. The ulnar, median, and radial nerves were located, and the minimum effective LA volume was investigated starting with a total of 21 ml of bupivacaine 0.5%. After accomplishing the blockage, the volume was decreased by 0.5 ml for each nerve. Block administration time, block onset times, anesthesia times, and time to first analgesic requirement were recorded.ResultsThe minimum effective LA volume for each nerve was 2.5 ml for a total of 7.5 ml. In comparing block administration times, there were no differences between high or low volume groups. It was found that sensory block onset time was 17 minutes for 7.5 ml and 11 minutes for 21 ml; sensory block regression time was six hours for 7.5 ml and 10.4 hours for 21 ml, respectively. This regression was statistically significant. The first analgesic requirement was 5.8 - 16.6 hours, respectively, for each group.ConclusionIn the administration of an USG-guided axillary block, sufficient anesthesia can be achieved by administering 2.5 ml of bupivacaine 0.5% for each nerve. However, it might be kept in mind that motor and sensory block onset time will be extended and regression time and time to the first analgesic requirement will be shorter with this volume. In addition, more advanced studies must be done for the determination of the optimum volume which can be used.
Highlights
IntroductionWith low rates of side effects, peripheral nerve blocks have recently started to be increasingly widely used in the provision of surgical anaesthesia levels and postoperative analgesia
Regional anaesthesia is currently accepted as a preferred application to general anaesthesia in suitable patients because of the provision of analgesia perioperatively and postoperatively, as well as reductions in perioperative morbidity, postoperative length of hospital stay, and costs [1].With low rates of side effects, peripheral nerve blocks have recently started to be increasingly widely used in the provision of surgical anaesthesia levels and postoperative analgesia.The plexus nerves can be blocked from the several desired points along the pathway
This study aimed to investigate the lowest volume of local anesthetic (LA) that is effective in ABPB applied under USG guidance in surgical interventions to the forearm, wrist, and hand regions of the upper extremity
Summary
With low rates of side effects, peripheral nerve blocks have recently started to be increasingly widely used in the provision of surgical anaesthesia levels and postoperative analgesia. The plexus nerves can be blocked from the several desired points along the pathway. A block from various levels of the brachial plexus is sufficient to provide anaesthesia of all the deep structures of the upper extremity and all the skin from above the distal arm as far as the mid-arm. How to cite this article Erdogmus N A, Baskan S, Zengin M, et al (August 03, 2021) What Is the Minimum Effective Volume of Local Anaesthetic Applied in Brachial Plexus Blockage With an Axillary Approach Under Ultrasonography Guidance?.
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