[Axillary blockade of the brachial plexus. A prospective evaluation of 1133 cases of plexus catheter anesthesia].
The results of 1133 axillary catheter brachial blocks are reported. Effectiveness and side-effects were monitored in a prospective manner over a period of 1 year.


METHODS
The puncture was performed with an 18-gauge plastic cannula fitted with a solid steel stylet. The stylet has a 45 degrees, short bevel with rounded edges. When puncturing the axillary neurovascular sheath, no attempt was made to elicit paresthesias with the needle. A distinct "click" and very easy advancement of the plastic cannula were signs of being well inside the neurovascular sheath. To confirm the correct positioning, 0.5-3 ml refrigerated saline solution were injected. If no paresthesias could be produced, a new puncture was performed using a nerve stimulator. The plastic cannula was fixed to the skin. For long-lasting operations or if postoperative analgesia or sympatholysis was required, a more flexible catheter was introduced through the plastic cannula. As an initial dose 40 ml 1% mepivacaine was injected via the cannula. If there was an insufficient block after 20 min, another 20 ml 1% mepivacaine was given. For long-lasting operations, 40 ml 1% mepivacaine was injected every 2 h.


RESULTS
Surgery was completed in 72% of patients; 24% required some form of supplementation including 17.2% of patients who received a "top-up" after 20 min (Table 1). In 3.8% of cases the technique was considered to be a complete failure, meaning that patients needed some type of general anesthesia including the use of i.v. ketamine.(ABSTRACT TRUNCATED AT 250 WORDS)
Büttner
J
J
Abteilung für Anaesthesie und Intensivmedizin der Berufsgenossenschaftlichen Unfallklinik, Ludwigshafen.
Kemmer
A
A
Argo
A
A
Klose
R
R
Forst
R
R
D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus; D002404:Catheterization / Q000295:instrumentation; D005069:Evaluation Studies as Topic; D006801:Humans; D008619:Mepivacaine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D011229:Preanesthetic Medication; D011446:Prospective Studies
D008619:Mepivacaine
Axilläre Blockade des Plexus brachialis. Eine prospektive Auswertung von 1133 Katheterplexusanaesthesien.