An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

Hdl Handle:
http://hdl.handle.net/10147/200995
Title:
An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.
Authors:
O'Donnell, Brian D; Iohom, Gabrielle
Affiliation:
Department of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland. briodnl@gmail.com
Citation:
An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block. 2009, 111 (1):25-9 Anesthesiology
Journal:
Anesthesiology
Issue Date:
Jul-2009
URI:
http://hdl.handle.net/10147/200995
DOI:
10.1097/ALN.0b013e3181a915c7
PubMed ID:
19512869
Abstract:
Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.; After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve.; The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases.; Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.
Item Type:
Article
Language:
en
Description:
BACKGROUND: Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block. METHODS: After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve. RESULTS: The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases. CONCLUSION: Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.
MeSH:
Adult; Aged; Axilla; Brachial Plexus; Dose-Response Relationship, Drug; Female; Humans; Lidocaine; Male; Middle Aged; Nerve Block; Statistics as Topic; Time Factors; Young Adult
ISSN:
1528-1175

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Donnell, Brian Den
dc.contributor.authorIohom, Gabrielleen
dc.date.accessioned2012-01-09T16:42:22Z-
dc.date.available2012-01-09T16:42:22Z-
dc.date.issued2009-07-
dc.identifier.citationAn estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block. 2009, 111 (1):25-9 Anesthesiologyen
dc.identifier.issn1528-1175-
dc.identifier.pmid19512869-
dc.identifier.doi10.1097/ALN.0b013e3181a915c7-
dc.identifier.urihttp://hdl.handle.net/10147/200995-
dc.descriptionBACKGROUND: Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block. METHODS: After ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve. RESULTS: The study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases. CONCLUSION: Successful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.en
dc.description.abstractUltrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.-
dc.description.abstractAfter ethical approval and informed consent, patients undergoing hand surgery of less than 90 min duration were recruited. A step-up/step-down study model was used with nonprobability sequential dosing based on the outcome of the previous patient. The starting dose of 2% LidoEpi was 4 ml per nerve. Block failure resulted in a dose increase of 0.5 ml; block success in a reduction of 0.5 ml.A blinded assistant assessed sensory and motor blockade at 5-min intervals up to 30 min. Block performance time and duration were measured. Two predetermined stopping points were used; a minimum of five consecutive block success/failures and five consecutive successful blocks at 1 ml per nerve.-
dc.description.abstractThe study was terminated when five consecutive patients had successful blocks using 1 ml of 2% LidoEpi per nerve (overall group n = 11). All five patients had surgical anesthesia within 10 min. The mean (SD) block performance time was 445 (100) s, and block duration was 190 min (range 120-310 min). All surgical procedures were performed under regional anesthesia with anxiolytic sedation provided in 3 of 11 cases.-
dc.description.abstractSuccessful ultrasound-guided axillary brachial plexus block may be performed with 1 ml per nerve of 2% LidoEpi.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAxilla-
dc.subject.meshBrachial Plexus-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLidocaine-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNerve Block-
dc.subject.meshStatistics as Topic-
dc.subject.meshTime Factors-
dc.subject.meshYoung Adult-
dc.titleAn estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.en
dc.typeArticleen
dc.contributor.departmentDepartment of Anaesthesia, Cork University Hospital, Wilton, Cork, Ireland. briodnl@gmail.comen
dc.identifier.journalAnesthesiologyen
dc.description.provinceMunster-
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