J Korean Pain Soc.  1997 Nov;10(2):225-230.

Continuous Axillary Brachial Plexus Block - I. Modification of Catheter insertion method -

• Lee HJ
• tae IS

Abstract

BACKGROUND
Authors modified the traditional continuous axillary brachial plexus block technique of Selander for purpose of increasing success rate and decreasing complications by use of commercial epidural anesthesia set. METHOD: Thirty-nine patients scheduled for upper extremity operations were injected with 40 ml of anesthetic solution by axillary perivascular technique, using 23-25G immobile needle at 2 cm from the pectoralis major. Tuohy needle was immediately introduced at 4 cm from the pectoralis major and pierced the expanded neurovascular sheath at an angle of 30 degree to the skin. The ""pop"" was well noted. Needle was advanced 0.5 to 3.0 cm and epidural catheter introduced through the needle. After removal of needle, occlusive dressing was done. Tip of catheter and spread of solution were demonstrated by fluoroscopy with contrast dye after completion of procedure. RESULT: Catheter insertion was successful at first attempt for all case. Total length of insertion was from 6 to 13 (10.0+/-1.7) cm. Tip of catheter was placed in infraclavicular space (66.7%), about the humeral head (17.9%) and in upper arm in 3 cases as U-shape (7.9%). Catheters were maintained for 6.7+/-2.6 (3-12) days. There were no complications such as: perforation of major vessels, needle trauma to nerve, infection, bleeding or hematoma.
CONCLUSION
This study demonstrated continuous axillary brachial plexus block with epidural anesthesia set is safe, easy and convenient modification of technique of Selander.

Keyword

Anesthetic Techniques, regional; Brachial plexus, catheterization

MeSH Terms

Anesthesia, Epidural
Arm
Brachial Plexus*
Catheters*
Fluoroscopy
Hematoma
Hemorrhage
Humans
Humeral Head
Needles
Occlusive Dressings
Skin
Upper Extremity