Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.10.004
Brazilian Journal of Anesthesiology
Short Communication

The effectiveness of the axillary plexus block in the resource-limited area of a low-income country, Ethiopia: a prospective cohort study

Fantahun Tarekegn, Misganew Terefe, Kassaw Moges

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Abstract

The brachial plexus block is the preferred regional anesthesia for upper limb surgery because it has the clinical benefits of less nausea and vomiting, longer pain relief, and earlier hospital discharge for outpatient surgery.1,2 According to Carlos A. and Jaime A.’s anatomical study, the median, radial, and ulnar nerves are found in discrete fascial compartments of the axillary neurovascular sheath.3 Burnham and his colleagues discovered that accumulating local anesthetic solution in the axillary sheath could make the blocking procedure easier and allow for a single axillary injection.4

The success rate of axillary plexus block is dependent on the loss of resistance to the axillary sheath.5 In addition, the standard criterion for the onset of the block was set arbitrarily at 30 minutes for the assessment of primary axillary block.6 A variety of tools are available to evaluate the effectiveness of axillary blockage, such as pinprick or loss of cold sensation with an icepack,7 and skin temperature.8

The main objective of our study was to establish the overall success rate and incidence of complications associated with the axillary plexus block with loss of resistance technique for forearm, wrist, or hand surgery.

References

1 DJ Pavlin, SE Rapp, NL Polissar, et al. Factors affecting discharge time in adult outpatients Anesthesia & Analgesia, 87 (1998), pp. 816-826

2 VW Chan, PW Peng, Z Kaszas, et al. A comparative study of general anesthesia, intravenous regional anesthesia, and axillary block for outpatient hand surgery: clinical outcome and cost analysis Anesth Analg, 93 (2001), pp. 1181-1184

3 CA Bollini, JA. Wikinski Anatomical review of the brachial plexus Techniques in Regional Anesthesia and Pain Management, 10 (2006), pp. 69-78

4 PJ. Burnham Regional block of the great nerves of the upper arm Anesthesiology, 19 (1958), pp. 281-284

5 T Vester-Andersen, C Christiansen, M Sørensen, et al. Perivascular axillary block II: influence of injected volume of local anaesthetic on neural blockade Acta Anaesthesiol Scand, 27 (1983), pp. 95-98

6 S Sia, M Bartoli, A Lepri, et al. Multiple-injection axillary brachial plexus block: a comparison of two methods of nerve localization–nerve stimulation versus paresthesia Anesth Analg, 91 (2000), pp. 647-651

7 M Curatolo, S Petersen-Felix, L Arendt-Nielsen, et al. Sensory assessment of regional analgesia in humans: a review of methods and applications Anesthesiology, 93 (2000), pp. 1517-1530

8 EM Galvin, S Niehof, HJ Medina, et al. Thermographic temperature measurement compared with pinprick and cold sensation in predicting the effectiveness of regional blocks Anesthesia & Analgesia, 102 (2006), pp. 598-604

9 H Pearce, D Lindsay, K Leslie Axillary brachial plexus block in two hundred consecutive patients Anaesth Intensive Care, 24 (1996), pp. 453-458

10 M Youssef, D. Desgrand Comparison of two methods of axillary brachial plexus anaesthesia Br J Anaesth, 60 (1988), pp. 841-844

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