Comparison of the lateral sagittal and costoclavicular approaches for ultrasound-guided infraclavicular block in pediatric patients: a prospective randomized study
Comparação das abordagens sagital lateral e costoclavicular para bloqueio infraclavicular guiado por ultrassom em pacientes pediátricos: um estudo prospectivo randomizado
Ahmet Murat Yayik, Sevim Cesur, Figen Ozturk, Erkan Cem Celik, Muhammet Emin Naldan, Ali Ahıskalıoğlu
Abstract
Background
The lateral sagittal brachial plexus block is the most used method for pediatric upper extremity surgery, whereas the applications of costoclavicular brachial plexus block are limited. This study aimed to compare the lateral sagittal and costoclavicular approaches for the ultrasound-guided infraclavicular block in pediatric patients.
Methods
Sixty pediatric patients aged 5–15 years undergoing hand or forearm surgery were randomly assigned to two groups. Group LS (n = 30) received ultrasound-guided lateral sagittal block, and Group CC (n = 30) received ultrasound-guided costoclavicular block. The block performing time, needling time, imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores were evaluated.
Results
The needling time (82.90 ± 28.17 seconds vs 64.77 ± 28.11 seconds respectively, p = 0.004) and total block performance time (109.53 ± 29.75 seconds vs 89.70 ± 29.98 seconds respectively, p = 0.005) were significantly longer in Group LS than in Group CC. However, there was no significant difference between the groups in imaging time, needle visibility, number of passes, sensorial/motor block time, and postoperative pain scores (p > 0.05).
Conclusions
Costoclavicular and lateral sagittal brachial plexus blocks resulted in similar anesthetics effects. Moreover, the costoclavicular method can be a better alternative to lateral sagittal as it has a shorter block performance time.
Keywords
Resumo
Introdução
O bloqueio sagital lateral do plexo braquial é o método mais utilizado para cirurgia pediátrica dos membros superiores, enquanto as aplicações do bloqueio costoclavicular do plexo braquial são limitadas. Este estudo teve como objetivo comparar as abordagens sagital lateral e costoclavicular para bloqueio infraclavicular guiado por ultrassom em pacientes pediátricos.
Métodos
Sessenta pacientes pediátricos com idades entre 5 e 15 anos submetidos a cirurgia de mão ou antebraço foram divididos aleatoriamente em dois grupos. O Grupo LS (n = 30) recebeu bloqueio sagital lateral guiado por ultrassom e o Grupo CC (n = 30) recebeu bloqueio costoclavicular guiado por ultrassom. Foram avaliados o tempo de realização do bloqueio, tempo de agulhamento, tempo de imagem, visibilidade da agulha, número de passadas, tempo de bloqueio sensorial/motor e escores de dor pós-operatória.
Resultados
O tempo de agulhamento (82,90 ± 28,17 segundos vs 64,77 ± 28,11 segundos, respectivamente, p = 0,004) e tempo total de desempenho do bloco (109,53 ± 29,75 segundos vs 89,70 ± 29,98 segundos, respectivamente, p = 0,005) . Entretanto, não houve diferença significativa entre os grupos no tempo de imagem, visibilidade da agulha, número de passagens, tempo de bloqueio sensorial/motor e escores de dor pós-operatória (p > 0,05).
Conclusão
Os bloqueios costoclavicular e sagital lateral do plexo braquial resultaram em efeitos anestésicos semelhantes. Além disso, o método costoclavicular pode ser uma alternativa melhor ao sagital lateral por apresentar menor tempo de realização do bloqueio.
Palavras-chave
Referências
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Submetido em:
22/07/2020
Aceito em:
08/05/2021
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