Clinical Evaluation of the Lateral Sagittal Infraclavicular Block Developed by MRI Studies

• DOI: 10.1016/j.rapm.2005.02.009
• Publication Date: 2005-07-17T12:33:11Z
• Authors: Z KOSCIELNIAKNIELSEN; H RASMUSSEN; L HESSELBJERG; Y GURKAN; B BELHAGE
• Keywords: Ropivacaine; Mepivacaine; Axilla; Interventional pain management

Lateral sagittal infraclavicular block by single injection has a faster performance time and causes less discomfort than does axillary multiple injections. This prospective, descriptive, multicenter study assessed effectiveness, onset time, incidence of adverse events verified the noninvasive measurements from magnetic resonance imaging (MRI).One hundred sixty patients were anesthetized use lateral following MRI recommendations for needle insertion. Each patient received mixture that contained equal volumes ropivacaine 7.5 mg/mL mepivacaine 20 with epinephrine 5 mug/mL, in total amount corresponded to 0.5 mL/kg (minimum 30 mL, maximum 50 mL). Block effectiveness (analgesia or anesthesia all nerves below elbow after minutes), times, insertion depth dorsal angle, twitch type, analgesia individual nerves, complications, as well patient's acceptance, recorded.One forty-three (91%) had successful blocks, 12 required supplementary nerve blocks axilla, 3 failures (no forearm at all), 2 excluded assessments. Median was 4 minutes (range, 2-10 minutes) 10-50 minutes). Plexus found mean 53 mm +/- 10 angle 23 degrees 9 . Four experienced painful paresthesias accidental punctures vessels. Signs symptoms complications (hematoma, local anesthetic toxicity, pneumothorax, neuropraxias) not observed. Only would prefer general future. Finger/wrist extension may be an optimal response (P = .14).Block (20 satisfactory comparable vertical paracoracoid approach. The low rate vessel (2%) most important advantage this block. confirmed findings, but steeper predicted.