Does circumferential spread of local anaesthetic improve the success of peripheral nerve block?
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摘要Background The relation between the pattern of local anaesthetic (LA) spread and the quality of peripheral nerve block is unclear. Methods Twenty-one volunteers were randomized to receive a median nerve block with intended circumferential or intended non-circumferential spread of LA. Different predetermined volumes and needle placement techniques were used to produce the different patterns of LA spread. Volumetric, multiplanar 3D ultrasound imaging was performed to evaluate the pattern and extent of LA spread. Sensory block was assessed at predetermined intervals. Results Complete circumferential spread of LA was achieved in only 67% of cases in the intended circumferential study group and in 33% of cases in the intended non-circumferential group. Block success was similar (90%) and independent of whether circumferential or non-circumferential spread of the LA was achieved. All block failures (n=4) occurred in the intended non-circumferential group with low volumes of LA. The onset of sensory block (independent of group allocation) was faster with circumferential spread of LA [median (IQR) onset time, 15 (8; 20) min] compared with non-circumferential spread of LA [median (IQR) onset time, 20 (15; 30) min]. More LA was used for circumferential blocks [median (IQR) volume of LA 2.8 (1.3; 3.6) vs 1.3 (1.1; 2.4) ml]. Conclusions Even under optimal conditions, it was not possible to achieve circumferential spread of LA in all intended cases. The success of median nerve block seems to be independent of the pattern of LA spread.
著者Marhofer D., Karmakar M.K., Marhofer P., Kettner S.C., Weber M., Zeitlinger M.
期刊名稱British Journal of Anaesthesia
出版年份2014
月份2
日期25
卷號113
期次1
出版社Oxford University Press
出版地United Kingdom
頁次177 - 185
國際標準期刊號0007-0912
電子國際標準期刊號1471-6771
語言英式英語
關鍵詞anaesthetic techniques, regional, equipment, ultrasound machines, regional anaesthesia

上次更新時間 2021-17-02 於 01:45