title: Transarterial brachial plexus anesthesia for hand surgery: a retrospective analysis of 346 cases.
abstract: OBJECTIVE
  To study the safety and efficacy of the transarterial approach to brachial plexus block with 60 to 70 ml of local anesthetic solution, and to compare the success and complication rates of this block performed by experienced or inexperienced anesthesiologists.
  
  
  METHODS
  Retrospective analysis of 346 records of ASA physical status I-IV patients who underwent elective unilateral orthopedic upper limb surgery with transarterial plexus anesthesia.
  
  
  METHODS
  University teaching hospital.
  
  
  RESULTS
  Blood pressure (BP) and heart rate were measured at 5-minute intervals. Analgesia was registered as successful, incomplete, or failed. Any patient complaints or adverse reactions were recorded. The first 60 ml of local anesthetic provided surgical analgesia to 64% of patients. With a supplemental 10 ml of anesthetic, the overall success rate was 94%, with only 19 of 346 patients requiring general anesthesia. Experience in performing the block increased the success rate from 90% to 98% (p < 0.001). Six patients experienced either nausea or a transient BP decrease that did not require medication. There was no record of toxic or other serious adverse reaction.
  
  
  CONCLUSIONS
  Transarterial brachial plexus block administered with a 60 to 70 ml dose of local anesthetic provides surgical analgesia for hand surgery with an excellent success rate and without serious adverse effects.
authors.affiliation: Department of Anesthesiology, Turku University Hospital, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Aantaa
authors.forename: O
authors.initials: O
authors.lastname: Kirvelä
authors.forename: A
authors.initials: A
authors.lastname: Lahdenperä
authors.forename: S
authors.initials: S
authors.lastname: Nieminen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia; D001132:Arm / Q000098:blood supply / Q000601:surgery; D001366:Axillary Artery; D001794:Blood Pressure / Q000187:drug effects; D001917:Brachial Plexus; D017558:Elective Surgical Procedures; D005260:Female; D006225:Hand / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012449:Safety
chemical_list: D011318:Prilocaine; D008012:Lidocaine