• Braz J Anesthesiol · Jan 2020

    Comparative Study

    [The need for supplemental blocks in single versus triple injections in infraclavicular brachial plexus blocks with a medial approach: a clinical and anatomic study].

    • Hande G Aytuluk and Tuncay Colak.
    • Kocaeli Derince Training and Research Hospital, Department of Anesthesiology and Reanimation, Kocaeli, Turquia; Kocaeli University Faculty of Medicine, Department of Anatomy, Kocaeli, Turquia. Electronic address: handegrbz@gmail.com.
    • Braz J Anesthesiol. 2020 Jan 1; 70 (1): 28-35.

    Background And ObjectivesTo evaluate the single-injection and triple-injection techniques in infraclavicular blocks with an ultrasound-guided medial approach in terms of block success and the need for supplementary blocks.MethodsThis study comprised 139 patients who were scheduled for elective or emergency upper-limb surgery. Patients who received an infraclavicular blocks with a triple-injection technique were included in Group T (n=68). Patients who received an infraclavicular blocks with a single-injection technique were included in Group S (n=71). The number of patients who required supplementary blocks or had complete failure, the recovery time of sensory blocks and early and late complications were noted.ResultsThe block success rate was 84.5% in Group S, and 94.1% in Group T without any need for supplementary nerve blocks. The blocks were supplemented with distal peripheral nerve blocks in 8 patients in Group S and in 3 patients in Group T. Following supplementation, the block success rate was 95.8% in Group S and 98.5% in Group T. These results were not statistically significant. A septum preventing the proper distribution of local anesthetic was clearly visualized in 4 patients. The discomfort rate during the block was significantly higher in Group T (p <0.05).ConclusionIn ultrasound-guided medial-approach infraclavicular blocks, single-injection and triple-injection techniques did not differ in terms of block success rates. The need for supplementary blocks was higher in single injections than with triple injections. The presence of a fascial layer could be the reason for improper distribution of local anesthetics around the cords.Copyright © 2020 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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