Clinical Study of Effectiveness of Peripheral Nerve Stimulator Guided Multiple Injection in Axillary Brachial Plexus Block
Authors/Creators
- 1. Senior Resident, Department of Anaesthesia, Ananta Institute of Medical Sciences and Research Centre, Siyol, Rajasthan
- 2. Assistant Professor, Department of Anaesthesia, Narendra Modi Medical College, Maninagar, Ahmadabad, Gujarat
- 3. Professor and Head, Department of Anaesthesia, Narendra Modi Medical College, Maninagar, Ahmadabad, Gujarat
- 4. first Year Resident, Department of Anaesthesia, Narendra Modi Medical College, Maninagar, Ahmadabad, Gujarat
Description
Background and Aim: Axillary brachial plexus block is one of the most widely used regional anesthesia technique for surgical procedures involving forearm, wrist, and hand. Peripheral nerve stimulator (PNS) was considered as the gold standard technique for nerve location. Present study was done with an aim to Study Effectiveness of Peripheral nerve stimulator guided multiple injection technique of axillary brachial plexus block. Material and Methods: Forty patients with physical status ASA grade I and II aged between 18 – 60 years, scheduled for elective hand, wrist and forearm surgeries were included in this study. Under all aseptic precautions, all patient were given peripheral nerve stimulator-guided axillary brachial plexus block with multiple injection technique was using 20 ml of 0.5% inj Bupivacaine and 20 ml of 2% inj Lignocaine with Adrenaline. All patients were observed for following parameters: Onset of sensory and motor block, Duration of sensory and motor block, Duration of analgesia, Hemodynamic changes, adverse effect/ complications. Results: Mean onset of sensory and motor block was 9.48 ± 1.28 min and 12.60 ± 0.98 min respectively. Mean Duration of sensory and motor block was 432.00 ± 78.61 min and 399.00 ± 76.49 min. Patients remained hemodynamically stable throughout the surgery and postoperatively. Mean duration of analgesia was 470.62 ± 81.65 min. VAS was increased with time. VAS at 1 hour was 0.07 ± 0.2667, VAS at 6 hours was 3.38 ± 0.69, and VAS at 8 hours was 4.00 ± 0.00. So, Rescue analgesic required mostly after 8 hrs post operatively. Conclusion: The peripheral nerve stimulator guided axillary brachial plexus block with multiple injection technique using 20 ml of 0.5% inj Bupivacaine and 20 ml of 2% inj Lignocaine with Adrenaline shorten the onset of sensory and motor block, prolong the duration of sensory and motor block and better postoperative analgesia without any major significant complications.
Abstract (English)
Background and Aim: Axillary brachial plexus block is one of the most widely used regional anesthesia technique for surgical procedures involving forearm, wrist, and hand. Peripheral nerve stimulator (PNS) was considered as the gold standard technique for nerve location. Present study was done with an aim to Study Effectiveness of Peripheral nerve stimulator guided multiple injection technique of axillary brachial plexus block. Material and Methods: Forty patients with physical status ASA grade I and II aged between 18 – 60 years, scheduled for elective hand, wrist and forearm surgeries were included in this study. Under all aseptic precautions, all patient were given peripheral nerve stimulator-guided axillary brachial plexus block with multiple injection technique was using 20 ml of 0.5% inj Bupivacaine and 20 ml of 2% inj Lignocaine with Adrenaline. All patients were observed for following parameters: Onset of sensory and motor block, Duration of sensory and motor block, Duration of analgesia, Hemodynamic changes, adverse effect/ complications. Results: Mean onset of sensory and motor block was 9.48 ± 1.28 min and 12.60 ± 0.98 min respectively. Mean Duration of sensory and motor block was 432.00 ± 78.61 min and 399.00 ± 76.49 min. Patients remained hemodynamically stable throughout the surgery and postoperatively. Mean duration of analgesia was 470.62 ± 81.65 min. VAS was increased with time. VAS at 1 hour was 0.07 ± 0.2667, VAS at 6 hours was 3.38 ± 0.69, and VAS at 8 hours was 4.00 ± 0.00. So, Rescue analgesic required mostly after 8 hrs post operatively. Conclusion: The peripheral nerve stimulator guided axillary brachial plexus block with multiple injection technique using 20 ml of 0.5% inj Bupivacaine and 20 ml of 2% inj Lignocaine with Adrenaline shorten the onset of sensory and motor block, prolong the duration of sensory and motor block and better postoperative analgesia without any major significant complications.
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IJTPR,Vol13,Issue8,Article14.pdf
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Additional details
Dates
- Accepted
-
2023-07-26
Software
References
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