Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.016
Brazilian Journal of Anesthesiology
Original Investigation

Is Jedi Grip efficient and effective in ultrasound-guided peripheral nerve blocking? A prospective, randomized, observer-blinded study

O Grip Jedi é eficiente e eficaz no bloqueio de nervos periféricos guiado por ultrassom? Um estudo prospectivo, randomizado e cego para observadores

Neslihan Keklik; Ismail Aytac; Semih Başkan; Betül Güven Aytaç

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Abstract

Background
In this prospective, randomized, controlled observer-blinded study, we aimed to compare the efficacy of a single-operator technique called the Jedi Grip and a conventional technique requiring a double operator in ultrasound–guided–axillary brachial plexus blocking.

Methods
Ninety-two patients (ASA I–II; aged 18–65 years old) who underwent elective hand, wrist and forearm surgery were randomly assigned to Group Conventional (C) or Group Jedi (J). In both groups, axillary plexus blockade was performed by applying 5 cc of a mixture of 10 cc of 0.5% bupivacaine and 10 cc of 2% prilocaine to the ulnar, radial, median, and musculocutaneous nerves. Parameters such as the performance time and number of needle passes were recorded during the procedure. Subsequently, a blinded observer evaluated and recorded parameters related to the blockade success. The main outcome variables were the performance time and success rate (surgical anesthesia).

Results
The block performance time of the Jedi technique was slightly longer than that of the conventional technique (220 (50), 202 (78) s, respectively) (median (IQR); p =  0.05). No significant difference was found between groups in terms of blocking success; 9 (20%) from the conventional group and 3 (6.4%) from the Jedi group were unsuccessful (p =  0.053). No differences were found in terms of arterial puncture, and no other complications occurred in either group. The motor-sensory block onset and termination times and initial analgesia requirements were similar.

Conclusion
The Jedi technique may be applied safely with similar block success and performance results as the conventional technique.

Keywords

Brachial plexus blockade;  Ultrasound, Interventional;  Anesthesia, Regional

Resumo

Justificativa: Neste estudo prospectivo, randomizado, controlado por observador-cego, nosso objetivo foi comparar a eficácia de uma técnica de operador único chamada Grip Jedi e uma técnica convencional que requer um operador duplo no bloqueio do plexo braquial axilar guiado por ultrassom. Métodos: Noventa e dois pacientes (ASA I–II; 18–65 anos) submetidos à cirurgia eletiva de mão, punho e antebraço foram aleatoriamente designados para o Grupo Convencional (C) ou Grupo Jedi (J). Em ambos os grupos, o bloqueio do plexo axilar foi realizado com a aplicação de 5 cc de uma mistura de 10 cc de bupivacaína a 0,5% e 10 cc de prilocaína a 2% nos nervos ulnar, radial, mediano e musculocutâneo. Parâmetros como o tempo de execução e o número de passagens da agulha foram registrados durante o procedimento. Posteriormente, um observador cego avaliou e registrou parâmetros relacionados ao sucesso do bloqueio. As principais variáveis de desfecho foram o tempo de realização e a taxa de sucesso (anestesia cirúrgica). Resultados: O tempo de execução do bloqueio da técnica Jedi foi ligeiramente superior ao da técnica convencional (220 (50), 202 (78) s, respectivamente) (mediana (IQR); p=0,05). Nenhuma diferença significativa foi encontrada entre os grupos em termos de sucesso do bloqueio; 9 (20%) do grupo convencional e 3 (6,4%) do grupo Jedi não obtiveram sucesso (p=0,053). Não foram encontradas diferenças em termos de punção arterial e não ocorreram outras complicações em nenhum dos grupos. Os tempos de início e término do bloqueio motor-sensorial e os requisitos iniciais de analgesia foram semelhantes. Conclusão: A técnica Jedi pode ser aplicada com segurança com sucesso de bloqueio e resultados de desempenho semelhantes à técnica convencional.

Palavras-chave

Bloqueio do plexo braquial; Ultrassonografia Intervencionista; Anestesia Regional

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