title: What benefits does ultrasound-guided axillary block for brachial plexus anaesthesia offer over the conventional blind approach in hand surgery?
abstract: Axillary block for brachial plexus anaesthesia is a popular anaesthetic technique for hand surgery with different approaches. We investigated the efficacy of the blind and ultrasound-guided approaches administered by a hand surgeon. A total of 141 patients were prospectively randomized to Group A without and Group B with ultrasound guidance. The principal variables evaluated were number of failures, duration of surgery, time to onset of anaesthesia, volume of anaesthetic injected, and complications. The success rate and the mean time to onset of anaesthesia were significantly better under ultrasound guidance. The duration of surgery and the rate of complications did not differ. Ultrasound-guided plexus anaesthesia is markedly more effective than the blind technique when performed by a hand surgeon.
authors.affiliation: Clinic of Plastic-, Reconstructive and Handsurgery, Aarau Cantonal Hospital, Aarau, Switzerland. benistrub@gmx.ch
authors.forename: B
authors.initials: B
authors.lastname: Strub
authors.forename: J
authors.initials: J
authors.lastname: Sonderegger
authors.forename: A
authors.initials: A
authors.lastname: Von Campe
authors.forename: J
authors.initials: J
authors.lastname: Grünert
authors.forename: J J
authors.initials: JJ
authors.lastname: Osterwalder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D001365:Axilla; D001917:Brachial Plexus / Q000000981:diagnostic imaging*; D002045:Bupivacaine / Q000008:administration & dosage; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D013566:Sympathomimetics / Q000008:administration & dosage; D013997:Time Factors; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D013566:Sympathomimetics; D008619:Mepivacaine; D002045:Bupivacaine; D004837:Epinephrine