[Optimal dose of local anesthetic mixture in ultrasound-guided infraclavicular brachial plexus block via coracoid approach: analysis of 160 cases].
OBJECTIVE
To investigate the optimal dose of local anesthetic mixture in ultrasound-guided infraclavicular brachial plexus block via coracoid approach.


METHODS
160 patients scheduled for surgery of the hand or forearm were randomly divided into 4 equal groups (Groups A, B, C, and D). To receive 8, 7, 6, or 5 ml of anesthetic mixture of 0.75% ropivacaine and 2% lidocaine for radial nerve, axillary nerve, median nerve, ulnar nerve, median cutaneous nerve of arm, median antebrachial cutaneous nerve, and lateral antebrachial cutaneous nerve respectively ultrasound-guided infraclavicular brachial plexus block via coracoid approach. The time for anesthesia taking effect, anesthesia maintenance time, and quality of sensory block were observed.


RESULTS
Anesthesia took effect about 4 minutes after injection in these 4 groups without significant differences among then (all P > 0.05). The good analgesic effect rates of Groups A, B, and C were all 100%, all significantly higher than that of Group D (87.5%, P = 0.027). The block maintenance times of Groups A, B, and C were (377 +/- 111) min, (369 +/- 135) min, and (351 +/- 112) min respectively, all significantly longer than that of Group D [(296 +/- 101) min, P = 0.024]. No anesthesia-related complication was found in these 4 groups.


CONCLUSIONS
Ultrasound-guided infraclavicular brachial plexus block via coracoid approach can reduce the volume of local anesthetic mixture. The dose of 6 ml local anesthetic mixture for each nerve fascicle, totally 18 ml, provides good analgesic effect and does not seem to affect the time for anesthesia taking effect.
Jiang
Xue-Bin
XB
Department of Anesthesiology, Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou, Wenzhou 325000, China.
Zhu
Su-Zhen
SZ
Jiang
Yi
Y
Chen
Qian-Huang
QH
Xu
Xu-Zhong
XZ
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D014463:Ultrasonography; D034941:Upper Extremity / Q000601:surgery*; D055815:Young Adult
D000779:Anesthetics, Local