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- Title
Perivascular axillary brachial plexus block and patient positioning: the influence of a lateral, head-down position.
- Authors
Orlowski, O.; Bullmann, V.; Vieth, V.; Filler, T.; Osada, N.; Van Aken, H.; Weber, T. P.
- Abstract
The aim of this study was to examine the effect of a 20° Trendelenburg position on the blockade of nerves that exit the brachial plexus proximally in patients undergoing single-injection axillary brachial plexus block. After a pilot study of eight cadavers suggested that a head-down and lateral position would encourage the proximal spread of local anaesthetic, 72 patients undergoing elective surgery were divided into two equal groups: a Supine group and a Modified Position group (lateral position, 20° head-down tilt). Patients were left in the allocated position for 30 min after an axillary block had been performed with alkalinised mepivacaine 1% 49.5 ml. Sensory and motor blockade evaluation showed that there was a significantly higher proportion of axillary nerve (76% vs. 0%, p < 0.001), thoracodorsal nerve (86% vs. 0%, p < 0.001) and subscapular nerve (89% vs. 0%, p < 0.001) blockade in the Modified Position group. Sensory block of the radial nerve was also improved by the modified position (100% vs. 86%, p < 0.05).
- Subjects
BRACHIAL plexus; ANESTHETICS; SURGERY; NERVES; INJECTIONS; BLOCKADE
- Publication
Anaesthesia, 2006, Vol 61, Issue 6, p528
- ISSN
0003-2409
- Publication type
Article
- DOI
10.1111/j.1365-2044.2006.04618.x