[Vertical infraclavicular brachial-plexus blockade. A clinical study of reliability of a new method for plexus anesthesia of the upper extremity].

We examined the efficacy of the vertical infraclavicular block for plexus brachialis anaesthesia using a nerve stimulator after introducing the method (VIP1) and after three years of clinical experience (VIP2). In two prospective studies we compared the results with each other as well as with the efficacy of the axillary block (AX). At VIP1, we found a complete analgesia in 88% of the patients, whereas in 9% a supplementation was needed. In group AX the results were significantly worse (complete: 70%, supplementation: 24%; p < 0.001). No increase of the rate of efficacy could be found when having some clinical experience with the VIP (VIP2: complete 87%, supplement: 11%). In general, the results of the VIP depended on the motoric answer to the nerve stimulation. There were no complications of the VIP such as nerve lesions or pneumothorax. The VIP using a nerve stimulator is a simple, reliable and uncomplicated method for plexus-brachialis-anaesthesia, which is easy to learn.