title: Axillary brachial plexus anesthesia: electrical versus cold saline stimulation.
abstract: The aim of this study was to investigate which of two methods of nerve stimulation, cold saline-induced paresthesia or use of a nerve stimulator, was more effective in increasing the successful brachial plexus block rate by the axillary approach. Twenty patients were randomly assigned to Group A (saline below 11 degrees C), and 20 patients to Group B (nerve stimulator). All blocks were performed by the same anesthesiologist using 40 mL of 1.5% mepivacaine and 4 mL of 8.4% sodium bicarbonate. Successful block was defined using Vester-Andersen et al.'s criteria. Cold saline-induced paresthesiae in the hand or forearm were obtained in 19 patients (95%) during one of four attempts allowed, and in 15 patients (75%) on the first attempt. A motor response was evoked by a nerve stimulator in 17 patients (85%). Two patients (10%) had a paresthesia in the hand without a motor response with the current at less than 1 mA. A successful block was achieved in 19 patients in each group.
authors.affiliation: Anesthesiology Department, Complexo Hospitalario Universitario de Santiago, Santiago University, Santiago de Compostela, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez
authors.forename: M
authors.initials: M
authors.lastname: Bárcena
authors.forename: J
authors.initials: J
authors.lastname: Alvarez
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage; D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus / Q000502:physiology*; D002021:Buffers; D003080:Cold Temperature; D004558:Electric Stimulation; D005260:Female; D005542:Forearm / Q000601:surgery; D006225:Hand / Q000601:surgery; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009046:Motor Neurons / Q000187:drug effects; D009119:Muscle Contraction / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D010292:Paresthesia / Q000503:physiopathology; D012677:Sensation / Q000502:physiology; D017693:Sodium Bicarbonate; D012965:Sodium Chloride
chemical_list: D000779:Anesthetics, Local; D002021:Buffers; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D008619:Mepivacaine