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

Material and method

Statistical method was:- T test for non parametrical data- Graph Prism 6

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.

Sex repartition

US GROUP NS GROUP

Vascular punctures

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.

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