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Comparison of the Clinical Efficacy of Three Perivascular Techniques for Axillary Brachial Plexus Block
  1. Rosemary Hickey, M.D.*,
  2. James N. Rogers, M.D.,
  3. Joan Hoffman, R.N., M.S.N.,
  4. Somayaji Ramamurthy, M.D.§ and
  5. Linda J. Tingle, M.D.
  1. From the Department of Anesthesiology, The University of Texas Health Science Center, San Antonio, Texas.
  2. *Associate Professor.
  3. Research Nurse and Instructor.
  4. Assistant Professor.
  5. §Professor.
  1. Address reprint requests or correspondence to Rosemary Hickey, M.D., Department of Anesthesiology, The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284.


Background and Objectives. This study compared the efficacy of three perivascular techniques of axillary block.

Methods. In group 1, all of the local anesthetic was injected after advancing the needle through the axillary artery (back of artery, n = 20); in group 2, after withdrawing slightly from the artery (front of artery, n = 20); and in group 3, half of the anesthetic was injected after advancing through and half after withdrawing from the axillary artery (half and half, n = 20). The local anesthetic used for the axillary block was 50 ml of 1.5% mepivacaine with epinephrine 1:200,000.

Results. The groups did not differ significantly in the incidence of analgesia or anesthesia expected in the median nerve distribution, where there was a significantly lower incidence of anesthesia in the back of the artery group. This group also had a slower onset of anesthesia for the median and the medial antebrachial cutaneous nerves.

Conclusions. There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.

  • Anesthetic techniques
  • regional
  • brachial plexus
  • axillary anesthetics
  • local
  • mepivacaine.

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  • Presented at the 17th Annual Meeting of the American Society of Regional Anesthesia, Tampa, Florida, March 1992.