You are here

  • Home
  • Archive
  • Volume 34, Issue 5
  • Does Local Anesthetic Dilution Influence the Clinical Effectiveness of Multiple-Injection Axillary Brachial Plexus Block?: A Prospective, Double-Blind, Randomized Clinical Trial in Patients Undergoing Upper Limb Surgery

Article Text

Article menu
Download PDFPDF
ORIGINAL ARTICLES
Does Local Anesthetic Dilution Influence the Clinical Effectiveness of Multiple-Injection Axillary Brachial Plexus Block?: A Prospective, Double-Blind, Randomized Clinical Trial in Patients Undergoing Upper Limb Surgery
  1. Laura Bertini, MD*,
  2. Stefano Palmisani, MD†,
  3. Stefania Mancini, MD*,
  4. Ornella Martini, MD*,
  5. Rossana Ioculano, MD* and
  6. Roberto Arcioni, MD†
  1. From the *Department of Trauma Anesthesia and Pain Management, Centro Traumatologico Ortopedico-ASL RMC; and
  2. †Department of Anesthesiology and Intensive Care Medicine, Second Faculty of Medicine, La Sapienza University of Rome, Azienda Ospedaliera Sant'Andrea, Rome, Italy.
  1. Address correspondence to: Stefano Palmisani, MD, Department of Anesthesiology and Intensive Care Medicine, Second Faculty of Medicine, La Sapienza University of Rome, Azienda Ospedaliera Sant'Andrea, Via di Grottarossa 1035, Rome, Italy (e-mail: stefano.palmisani{at}uniroma1.it).

Abstract

Objectives: The relationship between the dose, volume, and concentration of local anesthetic and the quality and success of regional anesthesia remains unclear. Our aim was to test whether using 3 different volumes of the same local anesthetic dose influences the success rate of an axillary brachial plexus block with a multiple-injection technique in patients undergoing upper limb surgery.

Methods: One hundred sixty-five patients were prospectively randomized to 1 of 3 groups. Each group received an axillary block with mepivacaine 400 mg, diluted in 3 different volumes (20, 30, and 40 mL). Outcome measures recorded were the block success rate at 30 mins, sensory and motor onset times, and length of postoperative sensory and motor blockade.

Results: No difference was found in the rate of successful axillary plexus blocks determined when the 30-min follow-up ended among the 3 groups: 94% for 20-mL volume, 94% for 30-mL volume, and 98% for 40-mL volume. The median sensory and motor onset times of anesthesia did not differ. However, postoperative motor blockade and sensory analgesia lasted significantly longer in the patients receiving mepivacaine 400 mg diluted in a volume of 30 mL than in the other groups.

Conclusions: An axillary brachial plexus block induced with a multiple-injection technique with mepivacaine 400 mg yields a high success rate regardless of the volume of anesthetic injected.

https://doi.org/10.1097/AAP.0b013e3181ae72b6

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.