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      Ultrasound and nerve stimulation-guided axillary Translated title: Bloqueo axilar guiado por ultrasonido y neuroestimulador

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          Abstract

          Introduction: The axillary block of the brachial plexus is widely used as an anaesthesia and analgesia technique in upper limb surgery, specifically for hand, wrist and forearm procedures. The use of nerve stimulation and ultrasound guidance has increased the rate of success with this block. Objective: This article presents a non-systematic review of the most recent literature on axillary block of the brachial plexus using ultrasound and peripheral nerve stimulation. Materials and methods: A search for a non-systematic review was conducted in the Cochrane, Pubmed/Medline, Embase and OVID databases. Conclusion: The axillary block of the brachial plexus is an anaesthetic and analgesic technique for upper limb surgery that has a high percentage of success, with a low degree of difficulty for the procedure.

          Translated abstract

          Introducción: El bloqueo axilar del plexo braquial es un bloqueo anestésico ampliamente utilizado como técnica anestésica y analgésica en cirugía de miembro superior, específicamente para mano, muñeca y antebrazo. El uso de neuroestimulador y ultrasonido ha aumentado la tasa de éxito de éste bloqueo. Objetivo: El presente artículo hace una revisión no sistemática de la literatura más reciente relacionada con el bloqueo axilar del plexo braquial utilizando ultrasonido y estimulación de nervio periférico. Métodos y Materiales: Se hizo una búsqueda en las bases de datos de Cochrane, Pubmed/Medline, Embase y OVID para la realización de una revisión no sistemática. Conclusión: El bloqueo del plexo braquial a nivel axilar es una técnica anestésica y analgésica para cirugía de miembro superior con alto porcentaje de éxito y bajo grado de dificultad en cuanto a realización del procedimiento.

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          Most cited references50

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          Brachial plexus anesthesia: A review of the relevant anatomy, complications, and anatomical variations.

          The trend towards regional anesthesia began in the late 1800s when William Halsted and Richard Hall experimented with cocaine as a local anesthetic for upper and lower limb procedures. Regional anesthesia of the upper limb can be achieved by blocking the brachial plexus at varying stages along the course of the trunks, divisions, cords and terminal branches. The four most common techniques used in the clinical setting are the interscalene block, the supraclavicular block, the infraclavicular block, and the axillary block. Each approach has its own unique set of advantages and indications for use. The supraclavicular block is most effective for anesthesia of the mid-humerus and below. Infraclavicular blocks are useful for procedures requiring continuous anesthesia. Axillary blocks provide effective anesthesia distal to the elbow, and interscalene blocks are best suited for the shoulder and proximal upper limb. The two most common methods for localizing the appropriate nerves for brachial plexus blocks are nerve stimulation and ultrasound guidance. Recent literature on brachial plexus blocks has largely focused on these two techniques to determine which method has greater efficacy. Ultrasound guidance has allowed the operator to visualize the needle position within the musculature and has proven especially useful in patients with anatomical variations. The aim of this study is to provide a review of the literature on the different approaches to brachial plexus blocks, including the indications, techniques, and relevant anatomical variations associated with the nerves involved.
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            What benefits does ultrasound-guided axillary block for brachial plexus anaesthesia offer over the conventional blind approach in hand surgery?

            Axillary block for brachial plexus anaesthesia is a popular anaesthetic technique for hand surgery with different approaches. We investigated the efficacy of the blind and ultrasound-guided approaches administered by a hand surgeon. A total of 141 patients were prospectively randomized to Group A without and Group B with ultrasound guidance. The principal variables evaluated were number of failures, duration of surgery, time to onset of anaesthesia, volume of anaesthetic injected, and complications. The success rate and the mean time to onset of anaesthesia were significantly better under ultrasound guidance. The duration of surgery and the rate of complications did not differ. Ultrasound-guided plexus anaesthesia is markedly more effective than the blind technique when performed by a hand surgeon.
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              Axillary block of the brachial plexus.

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rca
                Revista Colombiana de Anestesiología
                Rev. colomb. anestesiol.
                SCARE-Sociedad Colombiana de Anestesiología y Reanimación
                0120-3347
                January 2016
                : 44
                : 1
                : 30-35
                Affiliations
                [1 ] University of Western Ontario Canada
                [2 ] Hospital Pablo Tobón Uribe Colombia
                Article
                S0120-33472016000100007
                30d0c9ce-c0be-446d-a8b1-d8009d09b1a5

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=0120-3347&lng=en
                Categories
                ANESTHESIOLOGY

                Anesthesiology & Pain management
                Ultrasonografía,Ultrasonido,Anestesia de conducción,Bloqueo nervioso,Analgesia,Ultrasonography,Ultrasonics,Anesthesia Conduction,Nerve block

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