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Single vs. double stimulation during a lateral sagittal infraclavicular block
Author(s) -
AKYιLDιZ E.,
GÜRKAN Y.,
ÇAĞLAYAN Ç.,
SOLAK M.,
TOKER K.
Publication year - 2009
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2009.02085.x
Subject(s) - medicine , anesthesia , radial nerve , stimulation , elbow , lidocaine , levobupivacaine , block (permutation group theory) , local anesthetic , surgery , bupivacaine , geometry , mathematics
Background: The objective of this study was to evaluate the influence of single vs. dual control during an ultrasound‐guided lateral sagittal infraclavicular block on the efficacy of sensory block and the time of block onset. Methods: In a prospective manner, 60 adult patients scheduled for distal upper limb surgery were randomly allocated to single (Group S) or double stimulation (Group D) groups. A local anesthetic (LA) mixture of 20 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml with 5 μg/ml epinephrine (total 40 ml) was administered in both groups. In the Group S following a median, an ulnar or a radial nerve response, the entire LA was administered at a single site. In Group D 10 ml of LA was administered following the electrolocation of the musculocutaneous nerve and 30 ml LA was injected following median, ulnar or radial nerves. A successful block was defined as analgesia or anesthesia of all five nerves distal to the elbow. Sensory and motor blocks were tested at 5‐min intervals for 30 min. Results: The block was successful in 27 patients in Group S and 28 patients in Group D. The time from starting the block until satisfactory anesthesia was significantly shorter in Group D than in Group S (19.3 vs. 23.2 min) ( P <0.05). Total sensory scores were significantly higher in the double stimulation group at 20 and 30 min after the block performance ( P <0.05). Conclusions: Although the block performance time was longer in the double stimulation group, block onset time and extent of anesthesia were more favorable in the double stimulation group.