Ultrasound-guided axillary block versus ultrasound-guided infraclavicular block for upper extremity surgery

Background: Most upper limb regional anaesthesia techniques are successful, and differences in efficacy should dictate the choice of technique. Methods: This prospective, randomised study compares ultrasound-guided infraclavicular (IB) and ultrasound-guided axillary brachial plexus blocks (AB) for upper limb surgery. Anaesthesia time (performance time and onset time) was the primary outcome measure. The success rate (surgical anaesthesia), analgesia duration, postoperative pain scores, and the incidence of complications over the following 24 h were recorded. Results: A total of 82 patients were included in the study, and received either IB (n = 42) or AB (n = 40). No differences were observed between the 2 groups in terms of total anaesthesiarelated time, performance time, success rate (90-95%), or postoperative pain scores. Compared with the infraclavicular approach, ultrasound-guided AB group required a longer onset time, 10.2 min (SD +/- 1.4), than IB group, 6.35 min (SD +/- 2). IB was also associated with a longer analgesia duration than that of AB; 20 h (SD +/- 1.36) versus 13.70 h (SD +/- 2.16), respectively. The only complications we observed were uneventful vascular punctures. Conclusions: We can conclude that compared to ultrasound-guided AB, ultrasound-guided IB provides a similar efficacy, a shorter onset time and longer lasting analgesia. (C) 2012 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L. All rights reserved.