Single versus triple injection ultrasound-guided infraclavicular block: confirmation of the effectiveness of the single injection technique.
BACKGROUND
The optimal site for local anesthetic placement during ultrasound-guided infraclavicular block remains controversial.


METHODS
Patients were randomized to receive lidocaine 2% 30 mL as a single injection posterior to the axillary artery (n = 51) or a triple injection ideally adjacent to each brachial plexus cord (n = 49). Pinprick sensory and motor block (3 = no block, 0 = complete block) were assessed to 20 minutes in the 4 distal nerve territories.


RESULTS
The single injection group was not significantly inferior (single versus triple injection median [interquartile range] 20-minute aggregate block score: 5 [2-9] vs 7 [3.5-11]) but also demonstrated superiority (2-tailed test, P = 0.043). The single injection technique was associated with a small reduction in procedural time.


CONCLUSIONS
The optimal site for local anesthetic placement during ultrasound-guided infraclavicular block is a single point injection posterior to the axillary artery.
Fredrickson
Michael J
MJ
Department of Anaesthesiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. michaelfredrickson@yahoo.com
Wolstencroft
Philip
P
Kejriwal
Ritwik
R
Yoon
Albert
A
Boland
Michael R
MR
Chinchanwala
Simon
S
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001366:Axillary Artery / Q000000981:diagnostic imaging*; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000187:drug effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009407:Nerve Block / Q000379:methods*; D009520:New Zealand; D019637:Orthopedic Procedures; D012677:Sensation / Q000187:drug effects; D013997:Time Factors; D018084:Ultrasonography, Interventional
D000779:Anesthetics, Local; D008012:Lidocaine