title: Effective low dosage of mepivacaine in ultrasound-guided axillary nerve block: a double-blinded, randomized clinical trial of efficacy in patients undergoing distal upper extremity surgery.
abstract: OBJECTIVE
  To evaluate two low-dose volumes (20 mL or 30 mL) of 1.5% mepivacaine solution used for ultrasound-guided axillary blockade for outpatients undergoing distal upper limb surgery.
  
  
  METHODS
  Prospective, double-blinded randomized study.
  
  
  METHODS
  Outpatient surgical setting of a university-affiliated hospital.
  
  
  METHODS
  64 adult, ASA physical status 1, 2, and 3 patients, aged 28-46 years, scheduled for upper limb surgery.
  
  
  METHODS
  Patients were randomized to two groups to receive either 20 mL of 1.5% mepivacaine solution (n=31) or 30 mL of 1.5% mepivacaine solution (n=33) for ultrasound-guided axillary plexus blockade.
  
  
  METHODS
  Block duration, proportion of surgical and functional successful blocks, onset of sensory and motor blockade measured from 0 to 30 minutes following final needle extraction, total amount of preoperative sedative (midazolam), and intraoperative propofol administered were recorded.
  
  
  RESULTS
  Following axillary plexus blockade, neither patient group showed any statistically significant difference in the percentage of functionally successful blockade (30 mL, 100%: 20 mL, 97%; P = 0.48), surgically successful blockade (30 mL, 100%; 20 mL, 94%; P = 0.23), cumulative sensory or motor blockade surgical time, block performance time, preoperative midazolam use, or intraoperative propofol use.
  
  
  CONCLUSIONS
  Low volumes (30 mL or 20 mL) of 1.5% mepivacaine provides satisfactory anesthesia for ambulatory distal upper limb surgery with no significant difference in clinical outcomes.
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Receiving Hospital, Detroit, MI 48201, USA; Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201 USA. Electronic address: sperov@med.wayne.edu.
authors.forename: Samuel
authors.initials: S
authors.lastname: Perov
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201 USA.
authors.forename: Pranav
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201 USA.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Anesthesiology, Detroit Medical Center, Detroit, MI 48201 USA.
authors.forename: George M
authors.initials: GM
authors.lastname: McKelvey
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201 USA.
authors.forename: Elie
authors.initials: E
authors.lastname: Chidiac
authors.affiliation: Department of Anesthesiology, Wayne State University/Detroit Medical Center, Detroit, MI 48201 USA.
authors.forename: Faisal
authors.initials: F
authors.lastname: Motlani
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001917:Brachial Plexus; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional; D034941:Upper Extremity / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine
keywords: Axillary plexus block; Functional block; Mepivacaine; Regional anesthesia; Surgical block; Ultrasound-guided