Lateral Sagittal Infraclavicular Block for  Orthopedic Surgery: One Year Experience

Onur Palabıyık; Tuğba  Çağlar; Fikret  Bayar; Havva  Sayhan; Ayça  Taş Tuna; Yaşar  Toptaş; Yakup  Tomak; Ümit Karadeniz

doi:10.5152/EurJTher.2017.243

Authors

Onur Palabıyık Department of Anesthesiology and Reanimation, Sakarya University School of Medicine https://orcid.org/0000-0003-3876-4279
Tuğba Çağlar Department of Anesthesiology and Reanimation, Sakarya University Training and Research Hospital
Fikret Bayar Department of Anesthesiology and Reanimation, Sakarya University Training and Research Hospital
Havva Sayhan Department of Anesthesiology and Reanimation, Sakarya University School of Medicine
Ayça Taş Tuna Department of Anesthesiology and Reanimation, Sakarya University School of Medicine
Yaşar Toptaş Department of Anesthesiology and Reanimation, Sakarya University Training and Research Hospital
Yakup Tomak Department of Anesthesiology and Reanimation, Sakarya University School of Medicine
Ümit Karadeniz Department of Anesthesiology and Reanimation, Sakarya University School of Medicine

DOI:

https://doi.org/10.5152/EurJTher.2017.243

Keywords:

Infraclavicular block, ultrasound, nerve stimulator, success rate, orthopedic surgery

Abstract

Objective: Lateral sagittal infraclavicular block (LSIB) is commonly used as a regional anesthetic technique for below the mid-humerus region in upper-limb surgery. The primary aim of the present study was to analyze the success rate of LSIB for orthopedic surgery.
Methods: We retrospectively analyzed orthopedic surgical procedures and identified patients who were applied LSIB between January 2015 and December 2015. Patient age, gender, American Society of Anesthesiologists (ASA) classification, diagnosis, surgery time, premedication regimens, serious complications, and guidance type [ultrasound (US) or nerve stimulator (NS)] were recorded. Need for additional sedatives and analgesics, laryngeal mask airway anesthesia, and general anesthesia was documented. The successful block was defined as the block sufficient to perform the surgery without any additional anesthetic and analgesic methods.
Results: We identified 233 patients who underwent 244 orthopedic procedures. US-guided and NS-guided LSIB were applied in 170 (69.7%) and 74 (30.3%) procedures, respectively. Mean age, gender, ASA classification, surgery time, and premedication regimens were similar in both the groups. The success rates of US-guided and NS-guided LSIB were 95.3% and 83.8%, respectively, and this difference was significant as statistically.
Conclusion: US-guided LSIB had been gradually increased in our daily practice. Moreover, US-guided LSIB had a higher success rate than NS-guided LSIB.

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References

Klaastad Ø, Smith HJ, Smedby O, Winther-Larssen EH, Brodal P, Breivik H, et al. A novel infraclavicular brachial plexus block: the lateral and sagittal technique, developed by magnetic resonance imaging studies. Anesth Analg 2004; 98: 252-6.

Sandhu NS, Capan LM. Ultrasound-guided infraclavicular brachial plexus block. Br J Anaesth 2002; 89: 254-9.

Chin KJ, Alakkad H, Adhikary SD, Singh M. Infraclavicular brachial plexus block for regional anesthesia of the lower arm. Cochrane Database Syst Rev 2013; 8: CD005487.

Gurkan Y, Acar S, Solak M, Toker K. Comparison of nerve stimulation vs. ultrasound-guided lateral sagittal infraclavicular block. Acta Anaesthesiol Scand 2008; 52: 851-5.

Trabelsi W, Amor MB, Lebbi MA, Romdhani C, Dhahri S, Ferjani M. Ultrasound does not shorten the duration of procedure bua faster sensory and motor block onset in comparison to nerve stimulator in infraclavicular brachial plexus block. Korean J Anesthesiol 2013; 64: 327-33.

Rodríguez J, Barcena M, Lagunilla J, Alvarez J. Increased success rate with infraclavicular brachial plexus block using a dual-injection technique. J Clin Anesth 2004; 16: 251-6.

Gaertner E, Estebe JP, Zamfir A, Cuby C, Macaire P. Infraclavicular plexus block: multiple injection versus single injection. Reg Anesth Pain Med 2002; 27: 590-4.

Dhir S, Armstrong K, Armstrong P, Bouzari A, Mall J, Yu J, et al. A randomized comparison between ultrasound and nerve stimulation for infraclavicular catheter placement. Anesthesia 2016; 71: 198-204.

Sauter AR, Dodgson MS, Stubhaug A, Halstensen AM, Klaastad O. Electrical nerve stimulation or ultrasound guidance for lateral sagittal infraclavicular blocks: A randomized, controlled, observer-blinded, comparative study. Anesth Analg 2008; 106: 1910-5.

Brull R, Lupu M, Perlas A, Chan VW, McCartney CJ. Compared with dual nerve stimulation, ultrasound guidance shortens the time for infraclavicular block performance. Can J Anaesth 2009; 56: 812-8.

Koscielniak-Nielsen Z, Rasmussen H, Hesselbjerg L, Gurkan Y, Belhage G. Clinical evaluation of the lateral sagittal infraclavicular block developed by MRI Studies. Reg Anesth Pain Med 2005; 30: 329-34.

Klaastad O, Dodgson MS, Stubhaug A, Sauter AR. Lateral sagittal infraclavicular block (LSIB). Reg Anesth Pain Med 2006; 31:86.

Gürkan Y, Hosten T, Solak M, Toker K. Lateral sagittal infraclavicular block: clinical experience in 380 patients. Acta Anaesthesiol Scand 2008; 52: 262-6.

Koscielniak-Nielsen ZJ, Rasmussen H, Hesselbjerg L. Pneumothorax after an ultrasound-guided lateral sagittal infraclavicular block. Acta Anaesthesiol Scand 2008; 52: 1176-7.

Crews JC, Gerancher JC, Weller RS. Pneumothorax after coracoid infraclavicular brachial plexus block. Anesth Analg 2007; 105: 275-7.

Desroches J. The infraclavicular brachial plexus block by the coracoid approach is clinically effective: an observational study of 150 patients. Can J Anaesth 2003; 50: 253-7.