Comparative Analysis of the Efficiency of Blind and Controlled Techniques of Brachial Plexus Blockade

M.L. Homon


The aim: improve the quality of anesthesia in surgery on the upper extremity using blind and nervestimulater controlled blockade of the brachial plexus.
Materials and methods. There was performed a supraclavicular brachial plexus blockade in 41 patients while operative interventions on the upper extremity. In the first group of 21 patients plexus identified by paresthesia at angle of the injection needle of 45–90°. In the second group of 20 people identifying of the brachial plexus was performed using neurostimulator at an acute angle of the injection needle (30°) in a state of medication sleep through a combination of sibazon with thiopental or propofol. In both groups a combination of 1.5% lidocaine and 0.5% bupivacaine was used for a blockade.
Results and discussion. It was established that the use of blind brachial plexus blockade at right angles does not always provide adequate analgesic protection, is associated with increased systolic arterial pressure during surgery. A neurostimulator blockade at an acute angle of the injection needle (30°) provides 100% success blockade, stable hemodynamics, prolonged motor and sensory block, depth of anesthesia and requires fewer medications for analgesia and sedation. Anesthesia controlled by a neurostimulator in a state of medication sleep provides more comfortable state of a patient during surgery and better patient’s relation to anesthesia compared to the blind technique.
Conclusions. Summarizing the comparative analysis of both brachial plexus block techniques it was concluded that a neurostimulater identification of the brachial plexus and puncture at an acute angle (30°) provide better fullness and length of the block. This technique correlates with 100% successful anesthesia, higher analgetic effect, which requires fewer additional use of anesthetic drugs and narcotic analgesics, stable hemodynamic parameters, longer duration of anesthesia and patient’s better comfort during surgery.


blockade of the brachial plexus; surgery on the upper extremity


Lanhe M., Hluz A., Veeze R. Rehyonal'noe obezbolyvanye. Kratkoye rukovodstvo/ Pod red.. V.K. Yvchenko, Yu.Y.Nalapko. –Luhansk, Yzd. Luhanskoho HMU. -2004. -66s.

Mayer H., Byutner Y. Peryferycheskaya rehyonarnaya anestezyya: Atlas / [per. s anhl. pod red. P.R.Kamchatnova] –M.Bynom. Laboratoryya znanyy,- 2010. -260s.

Pod red. O.A.Tarabryna. Rehyonarnaya anestezyya. Tom 1. Verkhnyaya konechnost'.// -Harnytura Peterburh. 2010. -253s.

Rafmell D.P., Nyl D.N., Vyskoumy K.M. Rehyonarnaya anestezyya. — M.: MEDpress-ynform, 2007. — 272 s.

Smyrnova L.M. Orhanoprotektyvnost' rehyonarnoy anestezyy y antynotseotseptyvnoho vnutryvennoho narkoza. // Bol', obezbalyvanye y yntensyvnaya terapyya. 2012. -# 1. — S. 53-58

Strokan' A.M., Shlapak I.P. Peryferychna regionarna anesteziya.// Kyyiv. -2014. -142s.

Pashchuk A.Yu. Rehyonal'noe obezbolyvanye. // Moskva, -Medytsyna. 1987. — # 1. — S. 6-87.

Fesenko V.S. Blokady nerviv: Navchal'nyy posibnyk. –Kharkiv:TO Eksklyuzyv, 2002. -136s.

Arbona L. Fernando, Khabiri Babak, Norton John A. Ultrasound-Guided Regional Anesthesia: A Practical Approach to Peripheral Nerve Blocks and Perineural Catheters/ - Cambridge University Press . - 2011. - 194r.

Boezaart André. Anesthesia and Orthopaedic Surgery // McGraw-Hill Professional; 1 edition (July 1, 2006), - pp.81-90 and 291-330.

Boezaart Andre P. MD PhD. Atlas of Peripheral Nerve Blocks and Anatomy for Orthopaedic Anesthesia with DVD, 1e (The Atlases of Anesthesia Techniques Series) // Saunders; 1 Har/DVD edition (December 10, 2007), book#3. –p. 1-62.

Brain M., Randomized A. Clonidine Added to Continuous Intrerscalene Ropivacaine Perineural Infusion to Improve Postoperative Analgesia: Double-Blind, Controlled Study.// Anesth. Analg. -2005. -100. –p.1172-1178.

Didier A. Sciard, Matuszczak E.Maria. Landmarks for Peripheral Nerve Blocks: Upper and Lower Extremities. // Lippincott Williams & Wilkins.2011. –r. 2-31.

Hadzic Admir . Textbook of Regional Anesthesia and Acute Pain Management // McGraw-Hill Professional; 1 edition (December 4, 2006), -r. 24-28.

Litz R.J., Popp M., Stehr S.N., Koch T. Successful resuscitation of a patient with ropivacaine-induced asystole after axillary plexus block using lipid infusion // Anaesthesia. — 2006. — Vol. 61. — P. 800-801.

Mehrkens H., Geiger R., Winkelmann J. Peripheral Regional Anesthesia / –[2-nd expanded edition]. -2010. -95p.

Movafegh Ali, Razazian Mehran. Dexamethasone Added to Lidocaine Prolongs A[illary Brachial Plexus Blockade. // Anesth. Analg. -2006. -102. –p.263-267.

Rosenblatt M.A., Abel M., Fischer G.W.. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest // Anesthesiology. — 2006. — Vol. 105. — P. 217-218.

Copyright (c) 2016 EMERGENCY MEDICINE

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2018


   Seo анализ сайта