Ultrasound and nerve stimulation-guided axillary
Keywords:
Ultrasonography, Ultrasonics, Anesthesia Conduction, Nerve block, Analgesia
Abstract
Introduction: The axillary block of the brachial plexus is widely used as an anaesthesia and analgesia technique in upper limb surgery, specifically for hand, wrist and forearm procedures. The use of nerve stimulation and ultrasound guidance has increased the rate of success with this block.
Objective: This article presents a non-systematic review of the most recent literature on axillary block of the brachial plexus using ultrasound and peripheral nerve stimulation.
Materials and methods: A search for a non-systematic review was conducted in the Cochrane, Pubmed/Medline, Embase and OVID databases.
Conclusion: The axillary block of the brachial plexus is an anaesthetic and analgesic technique for upper limb surgery that has a high percentage of success, with a low degree of difficulty for the procedure.
References
1. Strub B, Sonderegger J, Von Campe A, Osterwalder JJ. What benefits does ultrasound-guided axillary block for brachial plexus anaesthesia offer over the conventional blind approach in hand surgery? J Hand Surg Eur. 2011;36:778-86.
2. Satapathy A, Coventry DM. Axillary brachial plexus block. Anesth Res Pr. 2011;2011:1-5.
3. Monkowski D, Gay Larese CS. Bloqueo axilar del plexo braquial. Rev Arg Anest. 2004;62:440-4.
4. Selander D. Axillary plexus block: paresthetic or perivascular. Anesthesiology. 1987;66:726-8.
5. Burnham PJ. Simple regional nerve block for surgery of the hand and forearm. J Am Med Assoc. 1959;169:941-3.
6. De Jong RH. Axillary block of the brachial plexus. Anesthesiology. 1961;22:215-25.
7. Thompson G, Rorie DK. Functional anatomy of the brachial plexus. Anesthesiology. 1983;59:117-22.
8. Ay S, Akinci M, Sayin M, Bektas U, Tekdemir I, Elhan A. The axillary sheath and single-injection axillary block. Clin Anat. 2007;20:57-63.
9. Kjelstrup T, Courivaud F, Klaastad 0, Breivik H, Hol PK. High-resolution MRI demonstrates detailed anatomy of the axillary brachial plexus. A pilot study. Acta Anaesthesiol Scand. 2012;56:914-9.
10. Luyet C, Constantinescu M, Waltenspul M, Luginbuhl M, Vogelin E. Transition from nerve stimulator to sonographically guided axillary brachial anesthesia in hand surgery. J Ultrasound Med. 2013;32:779-86.
11. Chan VW, Perlas A, McCartney CJ, Brull R, Xu D, Abbas S. Ultrasound guidance improves success rate of axillary brachial plexus block. Can J Anesth. 2007;54:176-82.
12. Bruce BG, Green A, Blaine TA, Wesner LV. Brachial plexus blocks for upper extremity orthopaedic surgery. J Am Acad Orthop Surg. 2012;20:38-47.
13. Toju K, Hakozaki T, Akatsu M, Isosu T, Murakawa M. Ultrasound-guided bilateral brachial plexus blockade with propofol-ketamine sedation. J Anesth. 2011;25:927-9.
14. Maga JM, Cooper L, Gebhard RE. Outpatient regional anesthesia for upper extremity surgery update (2005 to present) distal to shoulder. Int Anesth Clin. 2012;50:47-55.
15. Lecours M, Levesque S, Dion N, Nadeau M-J, Dionne A, Turgeon AF. Complications of single-injection ultrasound-guided infraclavicular block: a cohort study. Can J Anesth. 2013;60:244-52.
16. Gong D-J, Yuan H-J, Zhang Z-H. Axillary arteriovenous fistula after axillary plexus block. J Anesth. 2013;27:604-6.
17. Sites BD, Taenzer AH, Herrick MD, Gilloon C, Antonakakis J, Richins J, et al. Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks. Reg Anesth Pain Med. 2012;37:478-82.
18. Hanouz J-L, Grandin W, Lesage A, Oriot G, Bonnieux D, Gérard J-L. Multiple injection axillary brachial plexus block: influence of obesity on failure rate and incidence of acute complications. Anesth Analg. 2010;111:230-3.
19. Mian A, Chaudhry I, Huang R, Rizk E, Tubbs RS, Loukas M. Brachial plexus anesthesia: a review of the relevant anatomy. Complications, and anatomical variations. Clin Anat. 2014;27:210-21.
20. Remerand F, Laulan J, Couvret C, Palud M, Baud A, Velut S, et al. Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study. Anesth Analg. 2010;110:1729-34.
21. Wada T, Yamauchi M, Oki G, Sonoda T, Yamakage M, Yamashita T. Efficacy of axillary nerve block in elbow arthroscopic surgery: a randomized trial. J Shoulder Elb Surg. 2014;23:291-6.
22. Chin K, Alakkad H, Cubillos J. Single, double or multiple-injection techniques for non-ultrasound guided axillary brachial plexus block in adults undergoing surgery of the lower arm. Cochrane Database Syst Rev. 2013:CD003842.
23. Cuvillon P. Bloc axillaire, balance bénéfices/risques: quel est le bénéfice de lábord sous échographie? Ann Fr Anesth Reanim. 2012;31:e193-7.
24. Veneziano GC, Rao VK, Orebaugh SL. Recognition of local anesthetic maldistribution in axillary brachial plexus block guided by ultrasound and nerve stimulation. J Clin Anesth. 2012;24:141-4.
25. Da Conceicào DB, Helayel PE, de Oliveira Filho GR. A comparative study between ultrasound and neurostimulation guided axillary brachial plexus block. Rev Bras Anestesiol. 2009;59:585-91.
26. Silva MG, Sala-Blanch X, Marin R, Espinoza X, Arauz A, Morros C. Bloqueo axilar ecoguiado: variaciones anatómicas de la disposición de los 4 nervios terminales del plexo braquial en relación con la arteria humeral. Rev Esp Anestesiol Reanim. 2014;61:15-20.
27. Ustuner E, Yilmaz A, Õzgencil E, Okten F, Turhan SC. Ultrasound anatomy of the brachial plexus nerves in the neurovascular bundle at the axilla in patients undergoing upper-extremity block anesthesia. Skelet Radiol. 2013;42:707-13.
28. Duger C, Isbi AC, Kaygusuz K, Kol IO, Gursoy S. The importance of needle echogenity in ultrasound guided axillary brachial plexus block: a randomized controlled clinical study. Int J Med Sci. 2013;10:1108-12.
29. Vassiliou T, Müller H-H, Ellert A, Wallot P, Kwee K-M, Beyerle M, et al. High- versus low-stimulation current threshold for axillary plexus blocks: a prospective randomized triple-blinded noninferiority trial in 205 patients. Anesth Analg. 2013;116:247-54.
30. Nadeau M-J, Lévesque S, Dion N. Ultrasound-guided regional anesthesia for upper limb surgery. Can J Anesth. 2013;60:304-20.
31. Cho S, Kim YJ, Kim J-H, Baik H-J. Double-injection perivascular ultrasound-guided axillary brachial plexus block according to needle positioning: 12 versus 6 o'clock position of the axillary artery. Korean J Anesth. 2014;66:112-9.
32. Lopez-Morales S, Moreno-Martin A, Leal del Ojo J, Rodriguez-Huertas F. Bloqueo axilar ecoguiado frente a bloqueo infraclavicular ecoguiado para la cirugía de miembro superior. Rev Esp Anestesiol Reanim. 2013;60:313-9.
33. Sariguney D, Mahli A, Coskun D. The extent of blockade following axillary and infraclavicular approaches of brachial plexus block in uremic patients. J Clin Med Res. 2011;4: 26-32.
34. Ozcan E, Izdes S, Ozturk L, Kanbak O. Comparison of the efficacy of different concentrations and volumes of levobupivacaine in axillary brachial plexus blockade. Minerva Anestesiol. 2014;80:330-6.
35. Schoenmakers KPW, Wegener JT, Stienstra R. Effect of local anesthetic volume (15 vs 40 mL) on the duration of ultrasound-guided single shot axillary brachial plexus block: a prospective randomized, observer-blinded trial. Reg Anesth Pain Med. 2012;37:242-7.
36. González-Suárez S, Pacheco M, Roigé J, Puig MM. Comparative study of ropivacaine 0.5% and levobupivacaine 0.33% in axillary brachial plexus block. Reg Anesth Pain Med. 2009;34:414-9.
37. González AP, Bernucci F, Pham K, Correa JA, Finlayson RJ, Tran DQH. Minimum effective volume of lidocaine for double-injection ultrasound-guided axillary block. Reg Anesth Pain Med. 2013;38:16-20.
38. Ferraro LHC, Takeda A, dos Reis Falcão LF, Rezende AH, Sadatsune EJ, Tardelli MA. Determination of the minimum effective volume of 0.5% bupivacaine for ultrasound-guided axillary brachial plexus block. Rev Bras Anestesiol. 2014;64:49-53.
39. Yaghoobi S, Seddighi M, Yazdi Z, Ghafouri R, Khezri MB. Comparison of postoperative analgesic effect of dexamethasone and fentanyl added to lidocaine through axillary block in forearm fracture. Pain Res Treat. 2013;2013:1-6.
40. Koscielniak-Nielsen ZJ, Dahl JB. Ultrasound-guided peripheral nerve blockade of the upper extremity. Curr Opin Anesth. 2012;25:253-9.
41. Trifa M, Ben Khalifa S, Jendoubi A, Zribi N, Regaya T, Engelhardt T. Clonidine does not improve quality of ropivacaine axillar brachial plexus block in children. Paediatr Anaesth. 2012;22:425-9.
42. Kaygusuz K, Kol IO, Duger C, Gursoy S, Ozturk H, Kayacan U, et al. Effects of adding dexmedetomidine to levobupivacaine in axillary brachial plexus block. Curr Ther Res Clin Exp. 2012;73:103-11.
43. Zhang Y, Wang C, Shi J, Sun B, Liu S, Li P, et al. Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block. Int J Clin Exp Med. 2014;7:680-5.
44. Choi IG, Choi YS, Kim YH, Min JH, Chae YK, Lee YK, et al. The effects of postoperative brachial plexus block using MgSO4 on the postoperative pain after upper extremity surgery. Korean J Pain. 2011;24:158-63.
45. Senel AC, Ukinc O, Timurkaynak A. Does the addition of tramadol and ketamine to ropivacaine prolong the axillary brachial plexus block? Biomed Res Int. 2014: 686287.
46. Koh WU, Min HG, Park HS, Karm MH, Lee KK, Yang HS, et al. Use of hyaluronidase as an adjuvant to ropivacaine to reduce axillary brachial plexus block onset time: a prospective, randomised controlled study. Anaesthesia. 2015;70: 282-9.
47. Al E, Pirbudak L, Tahtaci N, Kul S. Combined axillary block with "selective" injection of nerves and the axillary catheter: comparison of bupivacaine 0.25% or levobupivacaine 0.25%. Middle East J Anesth. 2012;21:705-12.
48. Yu B, Zhang X, Sun P, Xie S, Pang Q. Non-stimulation needle with external indwelling cannula for brachial plexu block and pain management in 62 patients undergoing upper-limb surgery. Int J Med Sci. 2012;9:766-71.
49. Abd-Elsayed AA, Seif J, Guirguis M, Zaky S, Mounir-Soliman L. Bilateral brachial plexus home going catheters after digital amputation for patient with upper extremity digital gangrene. J Clin Med Res. 2011;3:325-7.
50. Roussel J, Thirkannad S. Compariso of 3 ultrasound-guided brachial plexus block approaches for cubital tunnel release surgery in 120 ambulatory patients. AANA J. 2014;82: 121-6.
2. Satapathy A, Coventry DM. Axillary brachial plexus block. Anesth Res Pr. 2011;2011:1-5.
3. Monkowski D, Gay Larese CS. Bloqueo axilar del plexo braquial. Rev Arg Anest. 2004;62:440-4.
4. Selander D. Axillary plexus block: paresthetic or perivascular. Anesthesiology. 1987;66:726-8.
5. Burnham PJ. Simple regional nerve block for surgery of the hand and forearm. J Am Med Assoc. 1959;169:941-3.
6. De Jong RH. Axillary block of the brachial plexus. Anesthesiology. 1961;22:215-25.
7. Thompson G, Rorie DK. Functional anatomy of the brachial plexus. Anesthesiology. 1983;59:117-22.
8. Ay S, Akinci M, Sayin M, Bektas U, Tekdemir I, Elhan A. The axillary sheath and single-injection axillary block. Clin Anat. 2007;20:57-63.
9. Kjelstrup T, Courivaud F, Klaastad 0, Breivik H, Hol PK. High-resolution MRI demonstrates detailed anatomy of the axillary brachial plexus. A pilot study. Acta Anaesthesiol Scand. 2012;56:914-9.
10. Luyet C, Constantinescu M, Waltenspul M, Luginbuhl M, Vogelin E. Transition from nerve stimulator to sonographically guided axillary brachial anesthesia in hand surgery. J Ultrasound Med. 2013;32:779-86.
11. Chan VW, Perlas A, McCartney CJ, Brull R, Xu D, Abbas S. Ultrasound guidance improves success rate of axillary brachial plexus block. Can J Anesth. 2007;54:176-82.
12. Bruce BG, Green A, Blaine TA, Wesner LV. Brachial plexus blocks for upper extremity orthopaedic surgery. J Am Acad Orthop Surg. 2012;20:38-47.
13. Toju K, Hakozaki T, Akatsu M, Isosu T, Murakawa M. Ultrasound-guided bilateral brachial plexus blockade with propofol-ketamine sedation. J Anesth. 2011;25:927-9.
14. Maga JM, Cooper L, Gebhard RE. Outpatient regional anesthesia for upper extremity surgery update (2005 to present) distal to shoulder. Int Anesth Clin. 2012;50:47-55.
15. Lecours M, Levesque S, Dion N, Nadeau M-J, Dionne A, Turgeon AF. Complications of single-injection ultrasound-guided infraclavicular block: a cohort study. Can J Anesth. 2013;60:244-52.
16. Gong D-J, Yuan H-J, Zhang Z-H. Axillary arteriovenous fistula after axillary plexus block. J Anesth. 2013;27:604-6.
17. Sites BD, Taenzer AH, Herrick MD, Gilloon C, Antonakakis J, Richins J, et al. Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks. Reg Anesth Pain Med. 2012;37:478-82.
18. Hanouz J-L, Grandin W, Lesage A, Oriot G, Bonnieux D, Gérard J-L. Multiple injection axillary brachial plexus block: influence of obesity on failure rate and incidence of acute complications. Anesth Analg. 2010;111:230-3.
19. Mian A, Chaudhry I, Huang R, Rizk E, Tubbs RS, Loukas M. Brachial plexus anesthesia: a review of the relevant anatomy. Complications, and anatomical variations. Clin Anat. 2014;27:210-21.
20. Remerand F, Laulan J, Couvret C, Palud M, Baud A, Velut S, et al. Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study. Anesth Analg. 2010;110:1729-34.
21. Wada T, Yamauchi M, Oki G, Sonoda T, Yamakage M, Yamashita T. Efficacy of axillary nerve block in elbow arthroscopic surgery: a randomized trial. J Shoulder Elb Surg. 2014;23:291-6.
22. Chin K, Alakkad H, Cubillos J. Single, double or multiple-injection techniques for non-ultrasound guided axillary brachial plexus block in adults undergoing surgery of the lower arm. Cochrane Database Syst Rev. 2013:CD003842.
23. Cuvillon P. Bloc axillaire, balance bénéfices/risques: quel est le bénéfice de lábord sous échographie? Ann Fr Anesth Reanim. 2012;31:e193-7.
24. Veneziano GC, Rao VK, Orebaugh SL. Recognition of local anesthetic maldistribution in axillary brachial plexus block guided by ultrasound and nerve stimulation. J Clin Anesth. 2012;24:141-4.
25. Da Conceicào DB, Helayel PE, de Oliveira Filho GR. A comparative study between ultrasound and neurostimulation guided axillary brachial plexus block. Rev Bras Anestesiol. 2009;59:585-91.
26. Silva MG, Sala-Blanch X, Marin R, Espinoza X, Arauz A, Morros C. Bloqueo axilar ecoguiado: variaciones anatómicas de la disposición de los 4 nervios terminales del plexo braquial en relación con la arteria humeral. Rev Esp Anestesiol Reanim. 2014;61:15-20.
27. Ustuner E, Yilmaz A, Õzgencil E, Okten F, Turhan SC. Ultrasound anatomy of the brachial plexus nerves in the neurovascular bundle at the axilla in patients undergoing upper-extremity block anesthesia. Skelet Radiol. 2013;42:707-13.
28. Duger C, Isbi AC, Kaygusuz K, Kol IO, Gursoy S. The importance of needle echogenity in ultrasound guided axillary brachial plexus block: a randomized controlled clinical study. Int J Med Sci. 2013;10:1108-12.
29. Vassiliou T, Müller H-H, Ellert A, Wallot P, Kwee K-M, Beyerle M, et al. High- versus low-stimulation current threshold for axillary plexus blocks: a prospective randomized triple-blinded noninferiority trial in 205 patients. Anesth Analg. 2013;116:247-54.
30. Nadeau M-J, Lévesque S, Dion N. Ultrasound-guided regional anesthesia for upper limb surgery. Can J Anesth. 2013;60:304-20.
31. Cho S, Kim YJ, Kim J-H, Baik H-J. Double-injection perivascular ultrasound-guided axillary brachial plexus block according to needle positioning: 12 versus 6 o'clock position of the axillary artery. Korean J Anesth. 2014;66:112-9.
32. Lopez-Morales S, Moreno-Martin A, Leal del Ojo J, Rodriguez-Huertas F. Bloqueo axilar ecoguiado frente a bloqueo infraclavicular ecoguiado para la cirugía de miembro superior. Rev Esp Anestesiol Reanim. 2013;60:313-9.
33. Sariguney D, Mahli A, Coskun D. The extent of blockade following axillary and infraclavicular approaches of brachial plexus block in uremic patients. J Clin Med Res. 2011;4: 26-32.
34. Ozcan E, Izdes S, Ozturk L, Kanbak O. Comparison of the efficacy of different concentrations and volumes of levobupivacaine in axillary brachial plexus blockade. Minerva Anestesiol. 2014;80:330-6.
35. Schoenmakers KPW, Wegener JT, Stienstra R. Effect of local anesthetic volume (15 vs 40 mL) on the duration of ultrasound-guided single shot axillary brachial plexus block: a prospective randomized, observer-blinded trial. Reg Anesth Pain Med. 2012;37:242-7.
36. González-Suárez S, Pacheco M, Roigé J, Puig MM. Comparative study of ropivacaine 0.5% and levobupivacaine 0.33% in axillary brachial plexus block. Reg Anesth Pain Med. 2009;34:414-9.
37. González AP, Bernucci F, Pham K, Correa JA, Finlayson RJ, Tran DQH. Minimum effective volume of lidocaine for double-injection ultrasound-guided axillary block. Reg Anesth Pain Med. 2013;38:16-20.
38. Ferraro LHC, Takeda A, dos Reis Falcão LF, Rezende AH, Sadatsune EJ, Tardelli MA. Determination of the minimum effective volume of 0.5% bupivacaine for ultrasound-guided axillary brachial plexus block. Rev Bras Anestesiol. 2014;64:49-53.
39. Yaghoobi S, Seddighi M, Yazdi Z, Ghafouri R, Khezri MB. Comparison of postoperative analgesic effect of dexamethasone and fentanyl added to lidocaine through axillary block in forearm fracture. Pain Res Treat. 2013;2013:1-6.
40. Koscielniak-Nielsen ZJ, Dahl JB. Ultrasound-guided peripheral nerve blockade of the upper extremity. Curr Opin Anesth. 2012;25:253-9.
41. Trifa M, Ben Khalifa S, Jendoubi A, Zribi N, Regaya T, Engelhardt T. Clonidine does not improve quality of ropivacaine axillar brachial plexus block in children. Paediatr Anaesth. 2012;22:425-9.
42. Kaygusuz K, Kol IO, Duger C, Gursoy S, Ozturk H, Kayacan U, et al. Effects of adding dexmedetomidine to levobupivacaine in axillary brachial plexus block. Curr Ther Res Clin Exp. 2012;73:103-11.
43. Zhang Y, Wang C, Shi J, Sun B, Liu S, Li P, et al. Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block. Int J Clin Exp Med. 2014;7:680-5.
44. Choi IG, Choi YS, Kim YH, Min JH, Chae YK, Lee YK, et al. The effects of postoperative brachial plexus block using MgSO4 on the postoperative pain after upper extremity surgery. Korean J Pain. 2011;24:158-63.
45. Senel AC, Ukinc O, Timurkaynak A. Does the addition of tramadol and ketamine to ropivacaine prolong the axillary brachial plexus block? Biomed Res Int. 2014: 686287.
46. Koh WU, Min HG, Park HS, Karm MH, Lee KK, Yang HS, et al. Use of hyaluronidase as an adjuvant to ropivacaine to reduce axillary brachial plexus block onset time: a prospective, randomised controlled study. Anaesthesia. 2015;70: 282-9.
47. Al E, Pirbudak L, Tahtaci N, Kul S. Combined axillary block with "selective" injection of nerves and the axillary catheter: comparison of bupivacaine 0.25% or levobupivacaine 0.25%. Middle East J Anesth. 2012;21:705-12.
48. Yu B, Zhang X, Sun P, Xie S, Pang Q. Non-stimulation needle with external indwelling cannula for brachial plexu block and pain management in 62 patients undergoing upper-limb surgery. Int J Med Sci. 2012;9:766-71.
49. Abd-Elsayed AA, Seif J, Guirguis M, Zaky S, Mounir-Soliman L. Bilateral brachial plexus home going catheters after digital amputation for patient with upper extremity digital gangrene. J Clin Med Res. 2011;3:325-7.
50. Roussel J, Thirkannad S. Compariso of 3 ultrasound-guided brachial plexus block approaches for cubital tunnel release surgery in 120 ambulatory patients. AANA J. 2014;82: 121-6.
How to Cite
1.
Lopera-Velásquez LM, Restrepo-Garcés C. Ultrasound and nerve stimulation-guided axillary. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Apr. 16];44(1):30-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/64
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2016-01-01
How to Cite
1.
Lopera-Velásquez LM, Restrepo-Garcés C. Ultrasound and nerve stimulation-guided axillary. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Apr. 16];44(1):30-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/64
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