title: A comparison between ultrasound-guided infraclavicular block using the "double bubble" sign and neurostimulation-guided axillary block.
abstract: BACKGROUND
  Ultrasound-guided infraclavicular block can be performed using the double bubble sign. Previously described, the double bubble sign consists superiorly of the axillary artery (in short axis) superimposed on an inferior bubble created by local anesthetic injection. In this study, we compared this new method of brachial plexus anesthesia to the traditional triple-nerve stimulation axillary block.
  
  
  METHODS
  Seventy patients were randomized to receive a single-injection, ultrasound-guided infraclavicular block using the double bubble sign or a triple-stimulation axillary block.
  
  
  RESULTS
  Both methods produced similar success rates (89%-91%). However, infraclavicular blocks were associated with a shorter performance time (3.90 +/- 2.27 vs 8.03 +/- 3.92 min; P < 0.001) and lower block-related pain scores (2.70 +/- 2.02 vs 4.17 +/- 2.57 on a 0-10 scale; P = 0.01).
  
  
  CONCLUSIONS
  Compared to triple-stimulation axillary block, ultrasound-guided infraclavicular block using the double bubble sign provided a similar efficacy, a shorter performance time and lower procedural pain scores.
authors: Montreal General Hospital, Department of Anesthesia, 1650 Ave. Cedar, D10-144, Montreal, Quebec, Canada. de_tran@hotmail.com
authors: De Q H
authors: DQ
authors: Tran
authors: Antonio
authors: A
authors: Clemente
authors: Don Q
authors: DQ
authors: Tran
authors: Roderick J
authors: RJ
authors: Finlayson
mesh_terms: D000328:Adult; D000368:Aged; D000777:Anesthetics / Q000494:pharmacology; D001365:Axilla / Q000473:pathology; D001366:Axillary Artery / Q000473:pathology; D001367:Axillary Vein / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management; D011826:Radial Nerve / Q000473:pathology; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
chemical_list: D000777:Anesthetics