title: [Anesthesia for upper limb surgery in a developing country: experience of infraclavicular and axillary blocks under neurostimulation].
abstract: Despite advances in regional anesthesia under ultrasound guidance, neurostimulation remains the primary technique in underequipped locations.
  
  
  METHODS
  We conducted a prospective descriptive study from January to December 2010 and June 2011 to May 2012 with as our main objective the assessment of the practices of infraclavicular and axillary nerve blocks (ICB and AXB, respectively) at Sylvanus Olympio University Hospital.
  
  
  RESULTS
  105 patients (11.8%) received ICB) and 75 patients (8.5%) axillary blocks (AXB). The average minimum intensity of neurostimulation was 0.4 mA (range: 0.25-0.45 mA. The mean volume of 0.5% bupivacaine used was 30 ± 10 mL. The mean onset time of the block was 15 ± 10 min, and the mean duration of action 6 ± 4 hours. Postoperative pain was significantly worse in patients who received ICB compared to AXB [χ(2) = 19.034, p = 0.00001<0.05]. The cost of either type of locoregional anesthesia under neurostimulation compared with general anesthesia was 44 euros versus 105 euros.
  
  
  CONCLUSIONS
  Peripheral nerve block by ICB and AXB under neurostimulation showed significant difference in terms of postoperative analgesia efficiency. Locoregional anesthesia remains too rarely practiced in underequipped countries despite its benefits and although it is particularly appropriate for these countries.
authors.affiliation: Département d'anesthésie réanimation, CHU Sylvanus Olympio, 08 BP, 8146 Lomé, Togo.
authors.forename: H D
authors.initials: HD
authors.lastname: Sama
authors.affiliation: Département d'anesthésie réanimation, CHU Sylvanus Olympio, 08 BP, 8146 Lomé, Togo.
authors.forename: A F
authors.initials: AF
authors.lastname: Ouro Bang'na Maman
authors.affiliation: Département d'anesthésie réanimation, CHU Sylvanus Olympio, 08 BP, 8146 Lomé, Togo.
authors.forename: P
authors.initials: P
authors.lastname: Egbohou
authors.affiliation: Département d'anesthésie réanimation, CHU Sylvanus Olympio, 08 BP, 8146 Lomé, Togo.
authors.forename: S
authors.initials: S
authors.lastname: Assénouwé
authors.affiliation: Département d'anesthésie réanimation, CHU Sylvanus Olympio, 08 BP, 8146 Lomé, Togo.
authors.forename: K
authors.initials: K
authors.lastname: Tomta
authors.affiliation: Département d'anesthésie réanimation CNHU Cotonou (Bénin).
authors.forename: M
authors.initials: M
authors.lastname: Chobli
mesh_terms: D000328:Adult; D000758:Anesthesia; D001132:Arm / Q000601:surgery*; D001365:Axilla / Q000294:innervation; D002968:Clavicle; D003906:Developing Countries; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods; D011446:Prospective Studies; D014037:Togo
keywords: Togo; axillary block; infraclavicular block; neurostimulation