Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Patna, India.
Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Patna, India.
Anaesth Crit Care Pain Med. 2021 Apr;40(2):100831. doi: 10.1016/j.accpm.2021.100831. Epub 2021 Mar 18.
Radial artery is a common site of cannulation in acute care setting. There are conflicting reports as to which nerve, radial or median or both supplies the radial artery. We did this prospective study in patients undergoing minor procedures under peripheral nerve blocks to ascertain which nerve block, radial or median increases the cross sectional area and blood flow in the radial artery.
Ninety ASA I/II patients undergoing upper limb minor surgeries under various blocks (radial or median or radial + median nerve) were enrolled in this study. Patients in group R were those who received Ultrasound-guided (USG) radial nerve block, group M median nerve block while group MR received both the nerve blocks. The primary objective was to assess the increase in cross sectional area (CSA) of radial artery in the groups after the block. Secondary objectives included assessment of time average maximum velocity (TAMAX) and blood volume (BV) after the block.
The CSA, TAMAX and BV of radial artery increased in all the three groups. Within each group the difference between the preblock and postblock parameters were highly significant. However, the differences are greater in groups M and M + R than in group R; (P < 0.001).
Ultrasound-guided median nerve block causes arterial vasodilation, and an increase in radial artery blood flow velocity. There was no added benefit of radial block along with median block in increasing the blood flow further.
桡动脉是急性护理环境中常见的插管部位。关于供应桡动脉的神经是桡神经还是正中神经，或者两者都有，存在相互矛盾的报道。我们在接受周围神经阻滞下进行小手术的患者中进行了这项前瞻性研究，以确定哪种神经阻滞（桡神经或正中神经或两者同时阻滞）会增加桡动脉的横截面积和血流量。
90 名接受上肢小手术的 ASA I/II 级患者纳入了这项研究，这些手术是在各种阻滞（桡神经或正中神经或桡神经+正中神经）下进行的。接受超声引导（USG）桡神经阻滞的患者分在 R 组，接受正中神经阻滞的患者分在 M 组，而接受两者神经阻滞的患者分在 MR 组。主要目的是评估阻滞后桡动脉横截面积（CSA）的增加。次要目的包括评估阻滞后的时间平均最大速度（TAMAX）和血流量（BV）。
三组患者的桡动脉 CSA、TAMAX 和 BV 均增加。每组内，阻滞前后参数的差异均具有高度显著性。然而，M 组和 M+R 组的差异大于 R 组（P<0.001）。
超声引导下正中神经阻滞可引起动脉扩张，增加桡动脉血流速度。与单独使用正中神经阻滞相比，同时使用桡神经阻滞并不能进一步增加血流量。
