Axillary Brachial Plexus Block with Peripheral Nerve Stimulator

Axillary block is a common anesthetic technique for operation on the hand and forearm. Many variations of the axillary approach have been described. Therefore we studied the results obtained when the axillary approach to brachial plexus blockade is attempted utilizing peripheral nerve stimulation(PNS).

Axillary brachial plexus block with PNS(0.5mA, 2Hz) was used in 30 adult patients undergoing hand and forearm surgery. 20ml of 1.5% lidocaine and 20ml of 0.375% bupivacaine solution was injected. A pin prick test was performed at 5, 10, 15, 20, 25 and 30 min. and quality of the clock in the distribution of 7 peripheral nerve of the brachial plexs was evaluated.

Block were 28 cases(93.3%) including 6 cases(20%) of incomplete block and total failure were 2 cases. Average number of blocked peripheral nerve of upper extrmity was 4.4±1.7. The order of rate of block was medial cutaneous n. of forearm, ulnar n., medial cutaneous n. of arm, median n., radial n., musculocutaneous n. and axillary n..

We found that a PNS can be utilized to establish blockade of the upper extrimity, but the success rate is not different than other methods, But it is appropriate for blocks established by beginner without complication.