دورية أكاديمية
Concomitant infraclavicular plus distal median, radial, and ulnar nerve blockade accelerates upper extremity anaesthesia and improves block consistency compared with infraclavicular block alone.
| العنوان: | Concomitant infraclavicular plus distal median, radial, and ulnar nerve blockade accelerates upper extremity anaesthesia and improves block consistency compared with infraclavicular block alone. |
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| المؤلفون: | Fredrickson MJ; Department of Anaesthesiology, Faculty of Medical and Health Sciences, University of Auckland, Epsom, Auckland, New Zealand., Ting FS, Chinchanwala S, Boland MR |
| المصدر: | British journal of anaesthesia [Br J Anaesth] 2011 Aug; Vol. 107 (2), pp. 236-42. Date of Electronic Publication: 2011 May 15. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: England NLM ID: 0372541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-6771 (Electronic) Linking ISSN: 00070912 NLM ISO Abbreviation: Br J Anaesth Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [London] : Elsevier Original Publication: London, Eng. [etc.] |
| مواضيع طبية MeSH: | Anesthetics, Local/*administration & dosage , Brachial Plexus/*diagnostic imaging , Nerve Block/*methods , Upper Extremity/*surgery, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amides/administration & dosage ; Anesthetics, Combined/administration & dosage ; Drug Administration Schedule ; Epinephrine/administration & dosage ; Female ; Humans ; Lidocaine/administration & dosage ; Male ; Median Nerve/diagnostic imaging ; Middle Aged ; Prospective Studies ; Radial Nerve/diagnostic imaging ; Ropivacaine ; Single-Blind Method ; Ulnar Nerve/diagnostic imaging ; Ultrasonography, Interventional/methods ; Young Adult |
| مستخلص: | Background: This prospective, randomized, observer-blinded study tested the hypothesis that a combined ultrasound-guided block of the infraclavicular brachial plexus plus distal median, radial, and ulnar nerves would accelerate upper extremity anaesthesia compared with infraclavicular block alone. Methods: Elective wrist and hand surgery patients were randomly assigned to receive 42 ml infraclavicular lidocaine 1.5% with epinephrine 1/200,000 ('infraclavicular only'; n=30) or 30 ml lidocaine 1.5% with epinephrine 1/200,000 followed by a distal median, radial, and ulnar nerve block using 12 ml 50:50 lidocaine 2%+ropivacaine 0.75% ('combined'; n=31). A blinded observer assessed pinprick sensory and motor block in the four distal nerve territories at 10 and 15 min (each nerve/parameter: no block, 3, to complete block, 0). Results: Total aggregate block score (sensory+motor) was reduced in the combined group at 15 min [mean (95% confidence interval)=6.7 (5.3-8.1) vs. 9.9 (7.9-11.9), mean difference (95% confidence interval)=3.2 (0.81-5.6), P=0.01], and corresponded to an estimated onset effect time benefit of 6 min (∼40% treatment effect). The combined group also demonstrated reduced variance about the mean (sd=3.7 vs. 5.4, P=0.046). Mean (sd) total block score (sensory+motor) was significantly reduced at 15 min in the combined group for each individual nerve [median, radial, ulnar, respectively: 1.4 (1.1) vs. 2.4 (1.5), P=0.005; 1.2 (1.1) vs. 2.0 (1.5), P=0.03; 1.6 (1.3) vs. 2.5 (1.6), P=0.03]. Conclusions: At an approximately equivalent total local anaesthetic dose, a combined infraclavicular block plus distal median, radial, and ulnar nerve blockade accelerates anaesthesia onset time and improves block consistency compared with an infraclavicular block alone. Clinical Trials Registry: ANZCTR: ACTRN12610000155099. https://www.anzctr.org.au/registry/trial_review.aspx?ID=335162. |
| التعليقات: | Comment in: Br J Anaesth. 2012 Mar;108(3):526; author reply 526-7. (PMID: 22337959) |
| المشرفين على المادة: | 0 (Amides) 0 (Anesthetics, Combined) 0 (Anesthetics, Local) 7IO5LYA57N (Ropivacaine) 98PI200987 (Lidocaine) YKH834O4BH (Epinephrine) |
| تواريخ الأحداث: | Date Created: 20110518 Date Completed: 20110907 Latest Revision: 20181201 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/bja/aer101 |
| PMID: | 21576095 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1471-6771 |
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| DOI: | 10.1093/bja/aer101 |