title: Infraclavicular brachial plexus block versus humeral approach: comparison of anesthetic time and efficacy.
abstract: Most upper arm regional anesthesia techniques are successful and differences in efficacy should not dictate the choice of technique. In the present study, we compared humeral block (HB) and infraclavicular brachial plexus block (ICB) using anesthetic time (i.e., duration of the procedure + onset time) as the primary outcome measure. The block was successful when a complete sensory block was obtained in the four major nerves of the arm, and the time to complete block was recorded. Patients undergoing orthopedic surgery of the upper limb were included in a prospective randomized study and received ICB (group I, n = 60 patients) or HB (group H, n = 60 patients). Total anesthetic time was 19.5 min (95% confidence interval [CI], 17.4-21.6 min) for ICB and 20.8 min (95% CI, 18.7--22.9 min) for HB (not significant). Time to perform the block was 4.5 min (95% CI, 4-5 min) for ICB and 9.8 min (95% CI, 8.9--10.7 min) for HB (P < 0.05). The onset time was 15 min (95% CI, 13-17 min) for ICB and 11 min (95% CI, 9--13 min) for HB (P < 0.05). The success rate was 92% for ICB and 95% for HB (not significant). One self-limited vascular puncture was made in each group. HB had a faster onset time but ICB using a double-stimulation technique was faster to perform. Anesthetic time was similar with the two techniques.
  
  
  CONCLUSIONS
  We have compared infraclavicular brachial plexus block (ICB) with humeral block. Efficacy and anesthetic time were not significantly different, although time to perform the block was shorter with the ICB.
authors.affiliation: *Department of Anesthesiology and Intensive Care, Toulouse University Hospital, Paul Sabatier University, Toulouse, France; †Department of Anesthesiology and Intensive Care, Bicêtre University Hospital, Le Kremlin-Bicêtre, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
authors.forename: Roland
authors.initials: R
authors.lastname: Amathieu
authors.forename: N'Guyen
authors.initials: N
authors.lastname: Luc
authors.forename: Claude
authors.initials: C
authors.lastname: Gris
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.forename: Kamran
authors.initials: K
authors.lastname: Samii
authors.forename: Dan
authors.initials: D
authors.lastname: Benhamou
mesh_terms: D000328:Adult; D000368:Aged; D001917:Brachial Plexus; D005260:Female; D006801:Humans; D006811:Humerus / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D034941:Upper Extremity / Q000601:surgery