Radial plus musculocutaneous nerve stimulation for axillary block is inferior to triple nerve stimulation with 2% mepivacaine.
OBJECTIVE
To compare the extent of sensory and motor block with two different nerve stimulation techniques in axillary blocks.


METHODS
Prospective, randomized, investigator-blinded study.


METHODS
Ambulatory surgery unit of a university hospital.


METHODS
60 ASA physical status I, II, and III patients undergoing surgery at or below the elbow.


METHODS
Patients receiving axillary block were randomized into two nerve stimulation groups with either radial plus musculocutaneous or triple nerve stimulation (radial, median, and musculocutaneous nerves). Thirty milliliters of plain 2% mepivacaine was given to all patients either in a single or fractionated dosing for radial or for radial and median nerves, according to group assignment. Five milliliters of plain 1% mepivacaine for the musculocutaneous nerve was given to all patients.


METHODS
Blocks were assessed at 10, 20, and 30 minutes. Rates of supplementation given as a result of insufficient surgical anesthesia were also noted.


RESULTS
Statistically significantly higher rates of anesthesia at the cutaneous distributions of median and medial cutaneous of the arm nerves with multiple nerve stimulation at 30 minutes were found as compared with radial plus musculocutaneous nerve stimulation. The rate of supplementation was lower with multiple nerve stimulation.


CONCLUSIONS
Radial plus musculocutaneous nerve stimulation showed lower efficacy of axillary block than did triple nerve stimulation when using 2% mepivacaine.
Rodríguez
Jaime
J
Department of Anesthesia, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain. jaime_rodriguez_garcia@yahoo.es
Taboada
Manuel
M
Oliveira
Juan
J
Ulloa
Beatriz
B
Bascuas
Begoña
B
Alvarez
Julián
J
D000779:Anesthetics, Local / Q000008:administration & dosage*; D001365:Axilla / Q000294:innervation; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve; D008619:Mepivacaine / Q000008:administration & dosage*; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009138:Musculocutaneous Nerve; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D011826:Radial Nerve; D012677:Sensation / Q000187:drug effects; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008619:Mepivacaine