Infraclavicular and supraclavicular approaches to brachial plexus for ambulatory elbow surgery: A randomized controlled observer-blinded trial.
Study Objective: To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery.Design: Prospective, parallel arm, observer-blinded, randomized controlled trial.Setting: This study occurred in a designated block room at St. Joseph's hospital...
| Publicado en: | Journal of Clinical Anesthesia pp. 67 - 73 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Elsevier B.V.
Aug2018
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130226109&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130226109 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09528180 JIK jtl: Journal of Clinical Anesthesia issn: 09528180 maglogo: N pubinfo: dt: Aug2018 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 130226109 130226109 NLM29778971 130226109 10.1016/j.jclinane.2018.05.005 NLM29778971 130226109 ppf: 67 ppct: 6 formats: tig: atl: Infraclavicular and supraclavicular approaches to brachial plexus for ambulatory elbow surgery: A randomized controlled observer-blinded trial. aug: au: Dhir, Shalini Brown, Brigid Mack, Peter Bureau, Yves Yu, Janice Ross, Douglas affil: Department of Anesthesiology and Perioperative Medicine, St. Joseph's Health Care, Western University, London, Ontario, Canada sug: subj: Orthopedic Surgery Adverse Effects Brachial Plexus Block Methods Postoperative Pain Prevention and Control Ambulatory Surgery Adverse Effects Paresthesia Epidemiology Middle Age Injections Adverse Effects Male Postoperative Pain Etiology Treatment Outcomes Human Brachial Plexus Block Adverse Effects Elbow Joint Adult Elbow Joint Surgery Brachial Plexus Drug Effects Elbow Innervation Ambulatory Surgery Methods Ultrasonography Aged Elbow Joint Innervation Incidence Elbow Female Anesthetics, Local Administration and Dosage Paresthesia Etiology Postoperative Pain Diagnosis Pain Measurement Brachial Plexus Injections Methods Elbow Surgery Orthopedic Surgery Methods Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Questionnaires Scales Middle Aged: 45-64 years Adult: 19-44 years Aged: 65+ years Male Female ab: Study Objective: To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery.Design: Prospective, parallel arm, observer-blinded, randomized controlled trial.Setting: This study occurred in a designated block room at St. Joseph's hospital, a large academic tertiary hospital in London, Canada.Patients: 150 adult ASA class I-III patients undergoing elective ambulatory elbow surgery.Interventions: Patients were randomized to receive either an ultrasound-guided infraclavicular or a supraclavicular block with ropivacaine.Measurements: Both groups were assessed for performance and sensory block onset times. Motor block, effective surgical anesthesia, procedure-related pain, axillary nerve block and ulnar nerve sparing were additional outcomes. We analyzed continuous and non-continuous variables with the independent t-test and chi-square test respectively and considered statistical significance when type 1 error was under 0.05.Main Results: We observed similar mean block procedure times at 285 (±128) seconds in infra and 307 (±138) seconds in supra group (p = 0.3). The mean time of sensory block onset in both groups was similar: Infra 20.4 (±7.9) and supra 18.9 (±7.1) min (p = 0.4). Conversion to general anesthesia (4.2 vs 5.5%; p = 0.73) and the need for local anesthetic supplement (4.2 vs 4.1%; p = 0.98) was similar in both groups. We observed an increased incidence of paresthesia in the supra group (8.3 vs 23.2%; p = 0.014).Conclusion: We found that both blocks were equally effective for elbow surgery with similar procedure and block onset times and failure rates. Lower incidence of paresthesia was associated with the infraclavicular block with no change in other complications compared to the supraclavicular technique. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|