title: Comfort and satisfaction during axillary brachial plexus block in trauma patients: comparison of techniques.
abstract: OBJECTIVE
  To investigate the comfort and satisfaction of patients with trauma of the upper limb during two different techniques of axillary brachial plexus block, electrical nerve stimulation and fascial pop.
  
  
  METHODS
  Randomized-prospective, observational study.
  
  
  METHODS
  University surgical center.
  
  
  METHODS
  100 ASA physical status I and II patients undergoing surgery for trauma of the hand and forearm.
  
  
  METHODS
  Patients received axillary brachial plexus block with a mixture of 0.5% bupivacaine and 2% lidocaine. They were then allocated to one of two groups to receive either electrical nerve stimulation (Group 1, n = 50), or fascial pop technique (Group 2, n = 50) for nerve location.
  
  
  METHODS
  Data were collected on patient demographics, surgery, frequency of complications, and sedation required during the block. Discomfort during the block and surgical comfort were quantified by visual analog scale (0-10). Satisfaction was determined by the following scale: very satisfied, satisfied, dissatisfied, and very dissatisfied. Patients also indicated if in the future they would like to receive the same method of anesthesia.
  
  
  RESULTS
  No differences in demographic or surgical data were found. No serious complications were observed. Eighteen Group 1 patients (36%) and none in Group 2 needed sedation during the blocks. Discomfort during the procedures was greater in Group 1 than Group 2 (4.5 +/- 1.2 vs 1.5 +/- 1, P < 0.05), while patients reported good surgical comfort with both techniques (2.4 +/- 2.9 vs 2.2 +/- 2.1, NS). Eighteen patients in Group 1 and 48 patients in Group 2 would accept the same block for future surgery.
  
  
  CONCLUSIONS
  In trauma patients, the fascial pop technique is effective, reduces sedation during axillary brachial plexus block, and has a higher patient acceptance rate than the electrical nerve stimulation technique.
authors.affiliation: Department of Anesthesia and Intensive Care, Orthopedic and Traumatologic Center, University Hospital Careggi, 50139 Florence, Italy. gianesello.lara@libero.it <gianesello.lara@libero.it>
authors.forename: Lara
authors.initials: L
authors.lastname: Gianesello
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pavoni
authors.forename: Roberta
authors.initials: R
authors.lastname: Coppini
authors.forename: Laura Tadini
authors.initials: LT
authors.lastname: Buoninsegni
authors.forename: Gabriele
authors.initials: G
authors.lastname: Gori
authors.forename: Emanuele
authors.initials: E
authors.lastname: Mori
authors.forename: Laura
authors.initials: L
authors.lastname: Paparella
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gritti
mesh_terms: D000368:Aged; D000779:Anesthetics, Local; D001134:Arm Injuries / Q000601:surgery*; D001365:Axilla; D001917:Brachial Plexus; D002045:Bupivacaine; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine