title: A comparison of posterior and medial cord stimulation for neurostimulation-guided vertical infraclavicular block: a randomized noninferiority clinical trial.
abstract: BACKGROUND
  We investigated whether medial cord stimulation is inferior to posterior cord stimulation for vertical infraclavicular block with respect to block success.
  
  
  METHODS
  Ninety-six patients scheduled for upper limb surgery were randomly elicited a medial or posterior cord response for infraclavicular block using 40 mL of 0.5% ropivacaine. We assessed block success (complete sensory block of the 5 nerves in the forearm at 50 minutes) as the primary end point and block procedure characteristics and adverse events as secondary end points.
  
  
  RESULTS
  The block success rates did not differ significantly between medial and posterior cord stimulation (95.7% [44/46] vs 91.7% [44/48], 95% CI of difference, -7.4% to 15.6%), while the secondary end points were comparable in both groups.
  
  
  CONCLUSIONS
  Needle manipulation to elicit medial cord response is noninferior to posterior cord response of block success during neurostimulation-guided vertical infraclavicular block.
authors.affiliation: From the *Department of Anesthesiology and Pain Medicine, Cheju Halla General Hospital, Jeju-si, Jeju special self-governing province; †Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, Daegu; ‡Department of Anesthesiology and Pain Medicine, Konyang university hospital, Daejeon; §Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang; and ‖Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Chun Woo
authors.initials: CW
authors.lastname: Yang
authors.forename: Sung Mee
authors.initials: SM
authors.lastname: Jung
authors.forename: Hee Uk
authors.initials: HU
authors.lastname: Kwon
authors.forename: Po Soon
authors.initials: PS
authors.lastname: Kang
authors.forename: Choon Kyu
authors.initials: CK
authors.lastname: Cho
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Oh
authors.forename: Younsuk
authors.initials: Y
authors.lastname: Lee
authors.forename: Junghee
authors.initials: J
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001917:Brachial Plexus; D004558:Electric Stimulation / Q000379:methods*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007431:Intraoperative Complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009339:Needles; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D059408:Pain Management; D010147:Pain Measurement; D010525:Peripheral Nerves / Q000502:physiology; D015742:Propofol; D013116:Spinal Cord / Q000502:physiology*; D014111:Tourniquets; D034941:Upper Extremity / Q000601:surgery
chemical_list: D006993:Hypnotics and Sedatives; D015742:Propofol