Comparative Study on the Brachial Plexus Block performed either by neurostimulation or by ultrasound guidance - Vascular Incidence Rate
Marisiensis 2015 - UMF Tg. Mures
First author: Gîndilă Emanuela DamarisLecturer: Szederjesi JanosAssistant professor: Lazăr Alexandra
1 - University of Medicine and Pharmacy of Tirgu-Mures - General Medical Assistance2- University of Medicine and Pharmacy of Tirgu-Mures - ATI Discipline
"This paper was published under the frame of European Social Found, Human Resources Development Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/136893"
Introduction
Regional brachial plexus block advantages: minimal degree of invasiveness use of a reduced number / reduced dosage of
medications- OPIOIDS no airway instrumentation and the maintenace of homeostasis of the main organs and systems.
Objective:
The study aims to evaluate the rate of vascular incidents encountered during regional anesthesia, by comparing two methods of performing:
1. By neurostimulation
2. By ultrasound guidance
Material and method:
Prospective, randomized study
100 adult patients with indication for handsurgery
The patients were divided into two groups of 50 - Neurostimulation group (NS) - Ultrasound group (US)
Material and method
In one group, anesthesia was performed byneurostimulation (NS):We used the Stimuplex,Bbraun
Material and methodIn the other group ultrasonography was used (US)We used the ultrasound from G&E Logique, General Electric
Material and method
• The patient was in a supine position
• The injured limb was abducted at a 110˚ and forearm at a 90˚
Material and method
• The anesthetic used was the echimolar admixture of :
-Ropivacaine-Lidocaine 0.5%
• The administered quantity was 0.4mg/kgc
Material and method
• We anesthetised the the following nervous structures:
• Median nerve• Ulnar nerve• Radial nerve• Musculocutaneus nerve
Material and method
• number of vascular incidents: arterial punctures venous punctures intravascular injection
Results:
Rate of the vascular incidents was 11%. (n=11).
By groups - 2 in the US group - 9 in the NS group p = 0, 025. No intravascular injections were recorded in the
two groups.
Conclusion:
The statistically significant difference of the rate of vascular incidents in the two groups reveals the fact that the brachial plexus block, performed by ultrasound guidance significantly reduces the vascular incidence rate during anesthesia.