Abstract
Background and Objectives: Todays, in order to avoid and prevent the complications associated with general anesthesia, the regional blocks are preferred. Among these blocks the brachial plexus block has a wider appeal, and because of the ease of application and fewer side effects, this block is widely used in different kinds of surgical procedure on elbow, forearm and hand. This block can be implemented using different methods such as transarterial and paraarterial approaches. The aim of the present study was to compare the two approaches with regard to their success rater, the speed of analgesia onset time and its duration, and their possible side effects.
Materials and Methods: The present study was curried out from Oct 2004 to Dec 2005 on 100 patients aged 16 and higher, with ASA physical status class of I to III, who had been admitted to Shohada hospital, Tabriz, for elbow, forearm and hand surgeries. The patients all of whom submitted written consent to undergoing brachial plexus block, randomly divided in to 2 groups: group T and group P.The local anesthetic used was 22.5m1 Lidocaine 2%, 17.5ml distilled water in total volume of 40ml and total dose of 450 mg, and 1/200000 epinephrine with a standard scalp veine 23 gauge, and 50 ml syringe.All the patients were sedated with fentanyl 1 µg/kg and Midazolam1-5 mg.
Results: There was no statistical difference between the groups in duration of analgesia but the onset of motor blockade was significantly faster in paraarterial method (3.5 minutes against 13.4 minutes; P<0.001). Success rate was 86% in T-group and 98% in P group (P=0.03). Two percent of patients in P group and 6% in T-group faced total failure of the block and 8% of the latter required supplementary drug.
Conclusion: In view of finding of the study, paraarterial method for axillary block is preferable due to faster onset of blockade and higher success rate.