A Modified Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique in 300 Patients
Infraclavicular brachial plexus block is used less than other techniques of regional anesthesia for upper-limb surgery. We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery...
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| Veröffentlicht in: | Anesthesia and analgesia 2005-01, Vol.100 (1), p.263-265 |
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| creator | Minville, Vincent NGuyen, Luc Chassery, Clement Zetlaoui, Paul Pourrut, Jean-Claude Gris, Claude Eychennes, Bernard Benhamou, Dan Samii, Kamran |
| description | Infraclavicular brachial plexus block is used less than other techniques of regional anesthesia for upper-limb surgery. We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery of the upper limb were included in this prospective study. The landmarks used were the coracoid process and the clavicle. The needle was inserted in the direction of the top of the axillary fossa (in relation to the axillary artery), with an angle of 45 degrees. Using nerve stimulation, the musculocutaneous nerve was identified first and blocked with 10 mL of 1.5% lidocaine with 1:400,000 epinephrine. The needle was then withdrawn and redirected posteriorly and medially. The radial, ulnar, or median nerve was then blocked. The block was tested every 5 min for 30 min. The overall success rate, i.e., adequate sensory block in the 4 major nerve distributions at 30 min, was 92%, and 6% of the patients required supplementation. Five patients required general anesthesia. No major complications were observed. This modified infraclavicular brachial plexus block using a double-stimulation technique was easy to perform, had frequent success, and was safe in this cohort. |
| doi_str_mv | 10.1213/01.ANE.0000142119.20284.9E |
| format | Article |
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We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery of the upper limb were included in this prospective study. The landmarks used were the coracoid process and the clavicle. The needle was inserted in the direction of the top of the axillary fossa (in relation to the axillary artery), with an angle of 45 degrees. Using nerve stimulation, the musculocutaneous nerve was identified first and blocked with 10 mL of 1.5% lidocaine with 1:400,000 epinephrine. The needle was then withdrawn and redirected posteriorly and medially. The radial, ulnar, or median nerve was then blocked. The block was tested every 5 min for 30 min. The overall success rate, i.e., adequate sensory block in the 4 major nerve distributions at 30 min, was 92%, and 6% of the patients required supplementation. Five patients required general anesthesia. No major complications were observed. This modified infraclavicular brachial plexus block using a double-stimulation technique was easy to perform, had frequent success, and was safe in this cohort.</description><identifier>ISSN: 0003-2999</identifier><identifier>EISSN: 1526-7598</identifier><identifier>DOI: 10.1213/01.ANE.0000142119.20284.9E</identifier><identifier>PMID: 15616088</identifier><identifier>CODEN: AACRAT</identifier><language>eng</language><publisher>Hagerstown, MD: International Anesthesia Research Society</publisher><subject>Adult ; Aged ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthetics, Local ; Biological and medical sciences ; Brachial Plexus ; Electric Stimulation ; Epinephrine ; Female ; Hand - surgery ; Humans ; Humerus - surgery ; Lidocaine ; Male ; Medical sciences ; Middle Aged ; Nerve Block - methods ; Orthopedic Procedures ; Prospective Studies</subject><ispartof>Anesthesia and analgesia, 2005-01, Vol.100 (1), p.263-265</ispartof><rights>International Anesthesia Research Society</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4447-e22335d8f8486279ff571211fc9edd1f66b37a14637e60e606b99dcd83f8846b3</citedby><cites>FETCH-LOGICAL-c4447-e22335d8f8486279ff571211fc9edd1f66b37a14637e60e606b99dcd83f8846b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00000539-200501000-00047$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,776,780,4010,4595,27900,27901,27902,65206</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16462443$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15616088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Minville, Vincent</creatorcontrib><creatorcontrib>NGuyen, Luc</creatorcontrib><creatorcontrib>Chassery, Clement</creatorcontrib><creatorcontrib>Zetlaoui, Paul</creatorcontrib><creatorcontrib>Pourrut, Jean-Claude</creatorcontrib><creatorcontrib>Gris, Claude</creatorcontrib><creatorcontrib>Eychennes, Bernard</creatorcontrib><creatorcontrib>Benhamou, Dan</creatorcontrib><creatorcontrib>Samii, Kamran</creatorcontrib><title>A Modified Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique in 300 Patients</title><title>Anesthesia and analgesia</title><addtitle>Anesth Analg</addtitle><description>Infraclavicular brachial plexus block is used less than other techniques of regional anesthesia for upper-limb surgery. We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery of the upper limb were included in this prospective study. The landmarks used were the coracoid process and the clavicle. The needle was inserted in the direction of the top of the axillary fossa (in relation to the axillary artery), with an angle of 45 degrees. Using nerve stimulation, the musculocutaneous nerve was identified first and blocked with 10 mL of 1.5% lidocaine with 1:400,000 epinephrine. The needle was then withdrawn and redirected posteriorly and medially. The radial, ulnar, or median nerve was then blocked. The block was tested every 5 min for 30 min. The overall success rate, i.e., adequate sensory block in the 4 major nerve distributions at 30 min, was 92%, and 6% of the patients required supplementation. Five patients required general anesthesia. No major complications were observed. This modified infraclavicular brachial plexus block using a double-stimulation technique was easy to perform, had frequent success, and was safe in this cohort.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthetics, Local</subject><subject>Biological and medical sciences</subject><subject>Brachial Plexus</subject><subject>Electric Stimulation</subject><subject>Epinephrine</subject><subject>Female</subject><subject>Hand - surgery</subject><subject>Humans</subject><subject>Humerus - surgery</subject><subject>Lidocaine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Orthopedic Procedures</subject><subject>Prospective Studies</subject><issn>0003-2999</issn><issn>1526-7598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkV1vFCEUQInR2LX6Fwwx0bcZ-RoGfNuuW21StYntM2EZcLDssB1mbI1_3tvuJksgN8C5XDgg9I6SmjLKPxJaL7-vawKNCkaprhlhStR6_QwtaMNk1TZaPUcLAHjFtNYn6FUpvx95ouRLdEIbSSVRaoH-LfG33MUQfYdXebQuxw4vd7sxW9fjKeOLIcBqsn-im5Md8RnM-mgTvkr-YS74LGV3W_BNicMvbPHnPG-Sr35OcQv4FPOAr73rh3g3exwHzAnBV7Duh6m8Ri-CTcW_OcRTdHO-vl59rS5_fLlYLS8rJ4RoK88Y502nghJKslaH0LTggQanfdfRIOWGt5YKyVsvCXS50bpzneJBKQGbp-jD_lx4FVyjTGYbi_Mp2cHnuRjZcsGJpAB-2oNuzKWMPpjdGLd2_GsoMY_qDaEG1JujevOk3ug1JL89VJk3W98dUw-uAXh_AGxxNoHWwcVy5KSQTAgOnNhz9zlNfiy3ab73o-m9TVP_VJo0XFcMAvwnIRUM0fL_1sSbvw</recordid><startdate>20050101</startdate><enddate>20050101</enddate><creator>Minville, Vincent</creator><creator>NGuyen, Luc</creator><creator>Chassery, Clement</creator><creator>Zetlaoui, Paul</creator><creator>Pourrut, Jean-Claude</creator><creator>Gris, Claude</creator><creator>Eychennes, Bernard</creator><creator>Benhamou, Dan</creator><creator>Samii, Kamran</creator><general>International Anesthesia Research Society</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050101</creationdate><title>A Modified Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique in 300 Patients</title><author>Minville, Vincent ; NGuyen, Luc ; Chassery, Clement ; Zetlaoui, Paul ; Pourrut, Jean-Claude ; Gris, Claude ; Eychennes, Bernard ; Benhamou, Dan ; Samii, Kamran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4447-e22335d8f8486279ff571211fc9edd1f66b37a14637e60e606b99dcd83f8846b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthetics, Local</topic><topic>Biological and medical sciences</topic><topic>Brachial Plexus</topic><topic>Electric Stimulation</topic><topic>Epinephrine</topic><topic>Female</topic><topic>Hand - surgery</topic><topic>Humans</topic><topic>Humerus - surgery</topic><topic>Lidocaine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Orthopedic Procedures</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minville, Vincent</creatorcontrib><creatorcontrib>NGuyen, Luc</creatorcontrib><creatorcontrib>Chassery, Clement</creatorcontrib><creatorcontrib>Zetlaoui, Paul</creatorcontrib><creatorcontrib>Pourrut, Jean-Claude</creatorcontrib><creatorcontrib>Gris, Claude</creatorcontrib><creatorcontrib>Eychennes, Bernard</creatorcontrib><creatorcontrib>Benhamou, Dan</creatorcontrib><creatorcontrib>Samii, Kamran</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minville, Vincent</au><au>NGuyen, Luc</au><au>Chassery, Clement</au><au>Zetlaoui, Paul</au><au>Pourrut, Jean-Claude</au><au>Gris, Claude</au><au>Eychennes, Bernard</au><au>Benhamou, Dan</au><au>Samii, Kamran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Modified Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique in 300 Patients</atitle><jtitle>Anesthesia and analgesia</jtitle><addtitle>Anesth Analg</addtitle><date>2005-01-01</date><risdate>2005</risdate><volume>100</volume><issue>1</issue><spage>263</spage><epage>265</epage><pages>263-265</pages><issn>0003-2999</issn><eissn>1526-7598</eissn><coden>AACRAT</coden><abstract>Infraclavicular brachial plexus block is used less than other techniques of regional anesthesia for upper-limb surgery. We describe a modified coracoid approach to the infraclavicular brachial plexus using a double-stimulation technique and assess its efficacy. Patients undergoing orthopedic surgery of the upper limb were included in this prospective study. The landmarks used were the coracoid process and the clavicle. The needle was inserted in the direction of the top of the axillary fossa (in relation to the axillary artery), with an angle of 45 degrees. Using nerve stimulation, the musculocutaneous nerve was identified first and blocked with 10 mL of 1.5% lidocaine with 1:400,000 epinephrine. The needle was then withdrawn and redirected posteriorly and medially. The radial, ulnar, or median nerve was then blocked. The block was tested every 5 min for 30 min. The overall success rate, i.e., adequate sensory block in the 4 major nerve distributions at 30 min, was 92%, and 6% of the patients required supplementation. Five patients required general anesthesia. No major complications were observed. This modified infraclavicular brachial plexus block using a double-stimulation technique was easy to perform, had frequent success, and was safe in this cohort.</abstract><cop>Hagerstown, MD</cop><pub>International Anesthesia Research Society</pub><pmid>15616088</pmid><doi>10.1213/01.ANE.0000142119.20284.9E</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics, Local Biological and medical sciences Brachial Plexus Electric Stimulation Epinephrine Female Hand - surgery Humans Humerus - surgery Lidocaine Male Medical sciences Middle Aged Nerve Block - methods Orthopedic Procedures Prospective Studies |
| title | A Modified Coracoid Approach to Infraclavicular Brachial Plexus Blocks Using a Double-Stimulation Technique in 300 Patients |
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