Comparative Study on the Brachial Plexus Block performed either by neurostimulation or by ultrasound guidance - Vascular Incidence Rate Marisiensis 2015.

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Comparative Study on the Brachial Plexus Block performed either by neurostimulation or by ultrasound guidance - Vascular Incidence Rate Marisiensis UMF Tg. Mures

First author: Gîndil ă Emanuela Damaris Lecturer: Szederjesi Janos Assistant professor: Laz ă r Alexandra 1 - University of Medicine and Pharmacy of Tirgu-Mures - General Medical Assistance 2- University of Medicine and Pharmacy of Tirgu-Mures - ATI Discipline "This paper was published under the frame of European Social Found, Human Resources Development Operational Programme , project no. POSDRU/159/1.5/S/136893"

Introduction Regional brachial plexus block advantages:  minimal degree of invasiveness  use of a reduced number / reduced dosage of medications- OPIOIDS  no airway instrumentation and the maintenace of  homeostasis of the main organs and systems.

Objective: The study aims to evaluate the rate of vascular incidents encountered during regional anesthesia, by comparing two methods of performing: 1.By neurostimulation 1.By ultrasound guidance

Material and method:  Prospective, randomized study  100 adult patients with indication for hand surgery  The patients were divided into two groups of 50 - Neurostimulation group (NS) - Ultrasound group (US)

Material and method In one group, anesthesia was performed by neurostimulation (NS): We used the Stimuplex,Bbraun

Material and method In the other group ultrasonography was used (US) We used the ultrasound from G&E Logique, General Electric

Material and method The patient was in a supine position The injured limb was abducted at a 110˚ and forearm at a 90˚

Material and method The anesthetic used was the echimolar admixture of : -Ropivacaine -Lidocaine 0.5% The administered quantity was 0.4mg/kgc

Material and method We anesthetised the the following nervous structures: Median nerve Ulnar nerve Radial nerve Musculocutaneus nerve

Material and method number of vascular incidents:  arterial punctures  venous punctures  intravascular injection

Material and method Statistical method was: -T test for non parametrical data -Graph Prism 6

Results:  Rate of the vascular incidents was 11%. (n=11).  By groups - 2 in the US group - 9 in the NS group p = 0, 025. No intravascular injections were recorded in the two groups.

Sex repartition US GROUPNS GROUP

Vascular punctures

Conclusion: The statistically significant difference of the rate of vascular incidents in the two groups reveals the fact that the brachial plexus block, performed by ultrasound guidance significantly reduces the vascular incidence rate during anesthesia.

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