Effect of local anaesthetic volume (20 vs 5 ml) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus block

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Presentation transcript:

Effect of local anaesthetic volume (20 vs 5 ml) on the efficacy and respiratory consequences of ultrasound-guided interscalene brachial plexus block S. Riazi, N. Carmichael, I. Awad, R.M. Holtby, C.J.L. McCartney British Journal of Anaesthesia Volume 101, Issue 4, Pages 549-556 (October 2008) DOI: 10.1093/bja/aen229 Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 1 Patient and probe/needle position for ultrasound-guided ISBPB as used in the present study. The anaesthetist can stand or sit in a relaxed position facing the ultrasound screen with the arm holding the ultrasound probe resting on the patient's shoulder whereas the other hand is free either to position the needle or to inject local anaesthetic. British Journal of Anaesthesia 2008 101, 549-556DOI: (10.1093/bja/aen229) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 2 Sonogram of the interscalene area at the C7 level. The needle approach is from the lateral aspect through the middle scalene muscle (ASM, anterior scalene muscle; MSM, middle scalene muscle; C5, C5 nerve root; C6, C6 nerve root). At this level, the C5 and C6 roots can commonly be seen to join to form the superior trunk of brachial plexus. British Journal of Anaesthesia 2008 101, 549-556DOI: (10.1093/bja/aen229) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 3 Patient flow through the study. British Journal of Anaesthesia 2008 101, 549-556DOI: (10.1093/bja/aen229) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 4 Number of patients with full sensation at baseline, after block placement, and after surgery. B, baseline; 10PB, 10 min post-block; 20PB, 20 min post-block; 30PB, 30 min post-block; 30PS, 30 min post-surgery; 60PS, 60 min post-surgery. *Significant difference in loss of sensation to pinprick between the groups. British Journal of Anaesthesia 2008 101, 549-556DOI: (10.1093/bja/aen229) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 5 Number of patients with preservation of movement in each muscle group. D, deltoid; B, biceps; T, triceps; M, finger flexion (median); R, finger extension (radial); U, finger abduction (ulnar). B, baseline; 10PB, 10 min post-block; 20PB, 20 min post-block; 30PB, 30 min post-block; 30PS, 30 min post-surgery; 60PS, 60 min post-surgery. *Significant difference in ability to move between the groups. British Journal of Anaesthesia 2008 101, 549-556DOI: (10.1093/bja/aen229) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions