Ultrasound guided single injection technique for infraclavicular block in arterio-venous shunt

Purpose: To evaluate the efficacy and safety of ultrasound technology for infraclavicular brachial plexus block in chronic renal failure patients undergoing arterio-venous shunt operations. Material and methods: Our study included 40 patients with fulfilled clinical criteria of chronic renal failure. All patients (32 RT and 8 LT sided) were subjected to infraclavicular block using ultrasound visualization with 7.5-10 MHz linear probe. The anesthetic mixture consisted of 20 ml lidocain hydrocarbonate 2% and 20 ml of plain bupivacaine 0.5%. Sensory block, motor block and supplementation rate were evaluated for the musculocutaneous, median, radial and ulnar nerves. Results: Surgical anesthesia was achieved without supplementation in 38 patients (95%) and 2 patients needed supplementation with infiltration anesthesia (5%). No patient in the study needed general anesthesia. Duration of surgery, administration, onset and complete blocks in minutes were (165 +/- 11.7, 11 +/- 4.5, 4.5 +/- 1.5 and 8.5 +/- 3.4), respectively. No vascular injury was reported in this study. Conclusion: We concluded that real-time ultrasound imaging during infraclavicular brachial plexus blocks can facilitate nerve localization, needle placement and provide high success rate. Also it improves safety for ICBPB. (C) 2011 Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V. All rights reserved.