Article Text
Abstract
Background and Aims The aim of this study is the description of an ultrasound-guided brachial plexus blockade at the level of the head of humerus where nerves are grouped around the axillary artery
Methods Ethics committee (CHU Liège. 2017/139–140) approved this study. 20 patients scheduled for hand and forearm surgeries were blocked in supine position, the arm abducted, the elbow flexed at 90 degrees. Musculocutaneous, median, ulnar and radial nerves (MCN, MN, UN, RN) were imaged in short axis with a linear probe. A 80 mm needle was inserted in-plane, lidocaïne 1.5% with epinephrine 1:400,000 was injected. Demographic data, efficacy, block performance times, injected volumes, onset times of sensory and motor blockades, discomfort (visual analogue scale :0–10 cm), side effects were recorded. Results are expressed as mean±SD, mixed models with Turkey’s multiple comparison tests were performed.
Results Complete sensory and motor blockades were obtained for 17 patients (Age: 52.75±13.48, BMI: 31.20±11.51) with 19.95±3.07 mL of lidocaine. Block performance time was 7.06±2.18 min, discomfort 2.00±1.89 cm. Onset times of sensory and motor blockades for MCN, MN, UN and RN were respectively 8.16±4.78, 8.25±4.67, 9.16±6.00, 8.82±4.85 min and 10.00±5.77, 11.50±5.40, 12.22±6.91, 10.29±5.99 min. Onset times of the 4 nerves were similar. One vascular puncture and 3 radial paresthesia occurred during blockade
Conclusions This study describes a novel and effective brachial plexus blockade technique at the level of the head of humerus where all nerves, far from the pleura, surround the axillary artery.