[Percutaneous catheterization of the newborn: control of pain and easy insertion with brachial plexus block].
The increasingly prolonged survival of extremely premature infants who required long-term venous access means that this is often a major problem in modern neonatal unit. The insertion of central venous catheters has become an established practice and the development of silastic catheters inserted by newer percutaneous techniques through a peripheral vein is, now, the choice technique in awake non sedated critically-ill infants. Such technique has an high percentage of failure. We have undertaken a retrospective study to determine whether the brachial plexus block performed via the axillary approach could improve the success rate for the insertion of central venous catheter from a peripheral vein of the upper limb in infants minimizing physical and emotional stress to the neonates. Data from 157 low and very low birthweight infants, submitted or not submitted to the axillary block, were examined. The failure rate for the insertion of the central venous catheter was 27% without using the brachial plexus block vs. 9% in the patients that underwent the block. Use of the brachial plexus block via the axillary route, although retrospectively evaluated, improves the success rate and the pain control for the insertion of small diameter central venous silicon catheter from a peripheral vein of the upper limb in low and very low birthweight infants.
Pignotti
M S
MS
Cattedra di Pediatria Preventiva e Sociale, Terapia Intensiva Neonatale, Ospedale Pediatrico A. Meyer, Firenze.
Messeri
A
A
Calamandrei
M
M
Donzelli
G P
GP
D001917:Brachial Plexus; D002404:Catheterization / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D009407:Nerve Block; D010146:Pain / Q000209:etiology; D059408:Pain Management; D012189:Retrospective Studies