Vastrad Vinuta Vidyanand, Mulimani Sridevi Mallanna, Talikoti Dayanand Gurubasappa, Sorganvi Vijaya M
Department of Anaesthesia, Shri B. M. Patil Medical College and Hospital, Vijayapura, Karnataka, India.
Department of Community Medicine, Shri B. M. Patil Medical College and Hospital, Vijayapura, Karnataka, India.
Anesth Essays Res. 2019 Jan-Mar;13(1):163-168. doi: 10.4103/aer.AER_184_18.
Axillary brachial plexus block (ABPB) is safest among other methods of brachial plexus block because of its ease and reliability. The two approaches of ultrasonography-guided ABPB are perivascular (PV) and perineural (PN).
This study was conducted to compare primary outcomes such as performance time, onset of the block, number of needle passes, block success rate, duration of sensory and motor block, and complications between ultrasound-guided PV and PN ABPB in patients posted for upper limb surgeries.
This prospective randomized study was conducted on 106 patients American Society of Anesthesiologists Class I and II posted for forearm, wrist, and hand surgeries, who were allotted into Group PV and Group PN 53 each.
In both methods, 20 mL of the drug was used. To start with, musculocutaneous nerve was blocked with 5 mL of the drug. In the PV technique, remaining 15 mL of the drug was deposited anterior and posterior to axillary artery, and in PN technique, 5 mL of the drug was injected around radial, ulnar, and median nerve.
Mann-Whitney and Chi-square test were used for statistical analysis.
Significant difference was observed between the two groups in performance time (PV - 8.647 ± 0.54 min and PN - 14.53 ± 0.20 min), onset time (PV - 19.48 ± 2.83 min and PN - 13.86 ± 1.81 min), and number of needle passes (PV - 2.30 ± 0.50 and PN - 4.91 ± 0.66). Other parameters were comparable in both the groups.
Ultrasound-guided PV axillary plexus block is better than PN axillary plexus block with respect to performance time and number of needle passes; but onset time was shorter in PN block, with precaution eliminating the risk of complications.
腋路臂丛神经阻滞（ABPB）因其操作简便且可靠，在臂丛神经阻滞的其他方法中最为安全。超声引导下的ABPB有两种入路，即血管周围（PV）入路和神经周围（PN）入路。
本研究旨在比较上肢手术患者中，超声引导下PV和PN ABPB在操作时间、阻滞起效时间、进针次数、阻滞成功率、感觉和运动阻滞持续时间以及并发症等主要结局方面的差异。
本前瞻性随机研究纳入了106例美国麻醉医师协会分级为I级和II级、拟行前臂、腕部和手部手术的患者，每组53例，分别分配至PV组和PN组。
两种方法均使用20 mL药物。首先，用5 mL药物阻滞肌皮神经。在PV技术中，将剩余的15 mL药物注入腋动脉前后；在PN技术中，将5 mL药物注射到桡神经、尺神经和正中神经周围。
采用曼-惠特尼检验和卡方检验进行统计分析。
两组在操作时间（PV组 - 8.647 ± 0.54分钟，PN组 - 14.53 ± 0.20分钟）、起效时间（PV组 - 19.48 ± 2.83分钟，PN组 - 13.86 ± 1.81分钟）和进针次数（PV组 - 2.30 ± 0.50，PN组 - 4.91 ± 0.66）方面存在显著差异。两组的其他参数相当。
在操作时间和进针次数方面，超声引导下的PV腋路臂丛神经阻滞优于PN腋路臂丛神经阻滞；但PN阻滞的起效时间较短，同时要注意预防并发症的风险。
