[Brachial plexus anesthesia via an axillary route for emergency surgery: comparison of three approach methods]. / Anesthésie du plexus brachial par voie axillaire pour chirurgie urgente: comparaison de trois méthodes d'approche.

ABSTRACT

OBJECTIVES: To compare three techniques of brachial plexus blockade for emergency surgery of the upper limb. STUDY DESIGN: Prospective, randomised study. PATIENTS One hundred eleven patients admitted to an emergency surgical service, randomly assigned to three groups. METHODS: The patients were given 2% lidocaine with epinephrine 20 mL and 0.5% bupivacaine 20 mL. The three groups were as follows brachial plexus block using a peripheral nerve stimulator (group St, n = 38); transarterial brachial plexus blockade with injection of 2/3 of the anaesthetic in back of and 1/3 in front of the artery (group TAP, n = 36); transarterial brachial plexus blockade with one single injection in back of the artery (group TP, n = 37). The success rate, time required to perform the technique, latency of analgesia, quality of motor blockade, and adverse effects were compared between the three groups. Analysis of variance was used to compare quantitative data and chi 2 test were used for qualitative data. RESULTS: Rates of success varied between 65 and 75%. Success rates, latency of analgesia and quality of motor blockade were not significantly different between groups. Time to perform the technique was longer when using a nerve stimulator. CONCLUSION: As these three techniques for brachial plexus block in emergency surgery are comparable, no one can be recommended instead of the others.