Staff Members - Benha University
Single-"Injection Nerve-Stimulation Technique For Interscalene Brachial Plexus Block: A Comparative Study Between Anterior And Posterior Approaches
• 2006
Publication Information
Authors
Mohamed Salem, MD ; Hamdy Eliwa, MD & Essam Al-Ghobashy MD
Keywords
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publication.type
Local
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Supplementary Materials
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Abstract
Objective: TI,is 1I1.lIlticellter study wns desiglleri to colllpnre t/le olltCOl/le ofillterscnlCl/(' block (l5B) mith lIer('c stili/illataI' dll rillg sholiider sllrgery IIsillg either the IlIlterior or posterior npproncll for block.
Patients & Methods: Comprised SO jJatiel/ts aJlocnted il/ 2 ('tll/al grollps accordillg to approucll IIscd: allterior (grol/p A) or posterior (group P). Both sCl/sory mid lIIotor block mere assessed as colilplete, illcolllpletc or.(llilllre. Block pl'rfonllllllcc tilllC, Intcucy tillle; dllrntioll of 1lI1IlIgcsia nll(/adl'crse cffccts werc recorded. Pnticllt colIIJort dl/rillg the I'roccdllrc wns euaillated 011 a 71isllal allalogllc 0-10 scale (VAS) alld j10tiellts wae askcd to nttribllte their discolllfort to either lIeedll' illscrtioll, IIcnl e stilll 11 latioll or both alld Wl'rC asked if they wOllldlilldcrgo the SII lIIe lIJ1c,lhct ic procerill re ill the fll t /I re if I/eeded.
Results: ISB pro7'ided colllplete block ill 47 pntiellts (94%), il/coII/plete block ill 2 paticllts (4%) IlIld fi1ilcd l>Io,-k ill all£' 1;lItiCllt (2%) ill grollp P Illld WIIS exclllded off the stl/dy. There mns n 1l01l-sigllijiCtlJll (p>O.OS) dl/krcllcc /JCtll'C(,1I both approachcs as regards tI,C Mock pel/orlllnllce tilllC, t/le latl'lIcy tilllC alld dllrntioll of tlIlIIlgcsia. MCt7l1 VAS ofdiscolI~fort dllrillg 158 was S.5±1.5, W pnticllts (20.5%) attribllted their discol1lfort to IIcer/le illsertioll, 16 plltiellts (32.7%) to lIerlle stilllllili/ioll IIl1d 23 pntiel/ts (46.8%) to both with II 11011slgll~ficallt (p>0.05) d~[fcrcl1cc behl'cl!lI both grOllps. Homcuer, 4.1 patiellts (82%) accepted to rcpcat thc prol'cdl/re if I/cl!ded iI/ ti,e flltil re. Adl'erse effects were ellcoltl/tered ill 9 patiel/ts (18.4%), mit" a 11011SiSlli(iCllllt di[fCl"cllc(' bet"ll'cclI bot" approac"es.
Conclusion: II could be col/ell/ded t"al sillgle-illicC/ioll lIen·c-stiIllJllatioll techlliql/c for illtasCtlICllc block I/sillS either allterior or posterior npproach provides prolollged cOlllplete II/Otor Illld sCl/sory block wit" lIIillilllnl IIdl'('rse erfeds /llId high patiellt' slltisfactiol/ witll t1 lIoII-sigllijimllt differellce betweel/ bOtJlllpprol1l'''es IIII/killg r1l1cst"ctist prefcrcllcc IIl1d cxpcricllcc to be t"e ollly guidc for choice.
Patients & Methods: Comprised SO jJatiel/ts aJlocnted il/ 2 ('tll/al grollps accordillg to approucll IIscd: allterior (grol/p A) or posterior (group P). Both sCl/sory mid lIIotor block mere assessed as colilplete, illcolllpletc or.(llilllre. Block pl'rfonllllllcc tilllC, Intcucy tillle; dllrntioll of 1lI1IlIgcsia nll(/adl'crse cffccts werc recorded. Pnticllt colIIJort dl/rillg the I'roccdllrc wns euaillated 011 a 71isllal allalogllc 0-10 scale (VAS) alld j10tiellts wae askcd to nttribllte their discolllfort to either lIeedll' illscrtioll, IIcnl e stilll 11 latioll or both alld Wl'rC asked if they wOllldlilldcrgo the SII lIIe lIJ1c,lhct ic procerill re ill the fll t /I re if I/eeded.
Results: ISB pro7'ided colllplete block ill 47 pntiellts (94%), il/coII/plete block ill 2 paticllts (4%) IlIld fi1ilcd l>Io,-k ill all£' 1;lItiCllt (2%) ill grollp P Illld WIIS exclllded off the stl/dy. There mns n 1l01l-sigllijiCtlJll (p>O.OS) dl/krcllcc /JCtll'C(,1I both approachcs as regards tI,C Mock pel/orlllnllce tilllC, t/le latl'lIcy tilllC alld dllrntioll of tlIlIIlgcsia. MCt7l1 VAS ofdiscolI~fort dllrillg 158 was S.5±1.5, W pnticllts (20.5%) attribllted their discol1lfort to IIcer/le illsertioll, 16 plltiellts (32.7%) to lIerlle stilllllili/ioll IIl1d 23 pntiel/ts (46.8%) to both with II 11011slgll~ficallt (p>0.05) d~[fcrcl1cc behl'cl!lI both grOllps. Homcuer, 4.1 patiellts (82%) accepted to rcpcat thc prol'cdl/re if I/cl!ded iI/ ti,e flltil re. Adl'erse effects were ellcoltl/tered ill 9 patiel/ts (18.4%), mit" a 11011SiSlli(iCllllt di[fCl"cllc(' bet"ll'cclI bot" approac"es.
Conclusion: II could be col/ell/ded t"al sillgle-illicC/ioll lIen·c-stiIllJllatioll techlliql/c for illtasCtlICllc block I/sillS either allterior or posterior npproach provides prolollged cOlllplete II/Otor Illld sCl/sory block wit" lIIillilllnl IIdl'('rse erfeds /llId high patiellt' slltisfactiol/ witll t1 lIoII-sigllijimllt differellce betweel/ bOtJlllpprol1l'''es IIII/killg r1l1cst"ctist prefcrcllcc IIl1d cxpcricllcc to be t"e ollly guidc for choice.