The Anesthetic Experiences of 200 Cases of Brachial Plexus Block by Parascalene Technique

Kil, Ho Yeong; Jin, Sang Ho; Kim, Hyoun Kon

Abstract

Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.