• Xavier March, Berta Pardina, Sílvia Torres-Bahí, Montse Navarro, Maria del Mar Garcia, and Antonio Villalonga.
• Department of Anesthesiology, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain. anestesia@htrueta.scs.es
• Reg Anesth Pain Med. 2003 Nov 1; 28 (6): 504-8.

Background And ObjectivesThis prospective, randomized, and single-blind study compared effectiveness, performance, onset, and total anesthetic time and complications of the multiple axillary block (median, radial, and musculocutaneous nerves) with the humeral approach.MethodsOne hundred patients were randomly assigned to 2 groups. In group A (axillary) median, radial, and musculocutaneus nerves were located by a nerve stimulator and injections were made. In group H (humeral) all 4 terminal nerves of the brachial plexus were located and injections were made. A total of 40 mL mepivacaine of 1% was used.ResultsComplete sensory block of all 6 peripheral nerves occurred in 94% and 79% of patients in groups A and H, respectively (P < .05). The time to perform the block was shorter in group A (8 +/- 4 minutes v 11 +/- 4 minutes; P < .001); onset time was shorter in group A (16 +/- 8 minutes v 21 +/- 9 minutes; P < .05); total anesthetic time was shorter in group A (24 +/- 8 minutes v 33 +/- 10 minutes; P < .0001). Complete motor block was greater in group A (88% v 66%; P < .05). More vascular punctures occurred in group A (22% v 8%, P < .05).ConclusionThe triple-injection axillary block was more effective than the humeral approach as it was associated with more cases of sensory and complete motor block and gave shorter performance and onset times.

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