Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2015.01.002
Brazilian Journal of Anesthesiology
Scientific Article

Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis

Orientação por ultrassom melhora a taxa de sucesso do bloqueio do plexo axilar: uma metanálise

Qin Qin; Debao Yang; Hong Xie; Liyuan Zhang; Chen Wang

http://dx.doi.org/10.1016/j.bjane.2015.01.002 Braz J Anesthesiol, vol.66, n2, p.115-119, 2016
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Abstract

ABSTRACT OBJECTIVE: To evaluate the value of real-time ultrasound (US) guidance for axillary brachial plexus block (AXB) through the success rate and the onset time. METHODS: The meta-analysis was carried out in the Anesthesiology Department of the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. A literature search of Medline, EMBASE, Cochrane database from the years 2004 to 2014 was performed. The literature searches were carried out using medical subject headings and free-text word: "axilla", "axillary", "brachial plexus", "ultrasonography", "ultrasound", "ultrasonics". Two different reviewers carried out the search and evaluated studies independently. RESULTS: Seven randomized controlled trials, one cohort study and three retrospective studies were included. A total of 2042 patients were identified. 1157 patients underwent AXB using US guidance (US group) and the controlled group included 885 patients (246 patients using traditional approach (TRAD) and 639 patients using nerve stimulation (NS)). Our analysis showed that the success rate was higher in the US group compared to the controlled group (90.64% vs. 82.21%, p < 0.00001). The average time to perform the block and the onset of sensory time were shorter in the US group than the controlled group. CONCLUSION: The present study demonstrated that the real-time ultrasound guidance for axillary brachial plexus block improves the success rate and reduce the mean time to onset of anesthesia and the time of block performance.

Keywords

Meta-analysis, Brachial plexus block, Ultrasonography

Resumo

RESUMO OBJETIVO: Avaliar o valor da orientação por ultrassonografia (US) em tempo real para bloqueio do plexo braquial por via axilar (BPBA) pela taxa de sucesso e tempo de latência. MÉTODOS: Uma metanálise foi feita no Departamento de Anestesiologia do Segundo Hospital Afiliado da Universidade de Soochow, Suzhou, província de Jiangsu, China. Fizemos uma pesquisa bibliográfica nas bases de dados Medline, Embasa e Cochrane de 2004 a 2014. A pesquisa foi feita com títulos de assuntos médicos e palavras de texto livre: axilla, axillary, brachial plexus, ultrasonography, ultrasound, ultrasonics. Dois revisores fizeram a pesquisa e avaliaram os estudos de forma independente. RESULTADOS: Sete estudos clínicos randômicos, um estudo de coorte e três estudos retrospectivos foram incluídos. Foram identificados 2.042 pacientes, dos quais 1.157 foram submetidos ao BPBA guiado por ultrassom (grupo US); o grupo controle incluiu 885 pacientes, dos quais 246 foram submetidos à abordagem tradicional (TRAD) e 639 à estimulação do nervo (EN). Nossa análise mostrou que a taxa de sucesso foi maior no grupo US em comparação com o grupo controle (90,64% vs. 82,21%, p< 0,00001). As médias do tempo necessário para fazer o bloqueio e do tempo de latência foram mais curtas no grupo US do que no grupo controle. CONCLUSÃO: O presente estudo demonstrou que a orientação por ultrassom em tempo real para o bloqueio do plexo braquial por via axilar melhora a taxa de sucesso e reduz a média do tempo de início da anestesia e do tempo de execução do bloqueio.

Palavras-chave

Metanálise, Bloqueio do plexo braquial, Ultrassonografia

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