Comparison of the anesthesia effect of ultrasound-guided middle and low interscalene brachial plexus block: a randomized, controlled, non-inferiority trial

BMC Anesthesiology

Research

Yang Zhao¹  Zhaohui Chen²  Xue Yang²  Chongmei Gao²  Shiming Qin²  Xia Yuan²  Tao Li³ 

[1] Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, 637000, Nanchong, Sichuan, People’s Republic of China;Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, No. 22 Shuangyong Road, 530021, Guangxi, People’s Republic of China;Department of Anesthesiology, Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), No.1 Shuanghu Branch Road, 401120, Chongqing, China;Department of Radiology, Chengdu Second People’s Hospital, 610017, Chengdu, Sichuan, China;

关键词: Block;    Brachial Plexus;    Methods;    Anesthesia;    Ultrasonography;    Elbow;   

DOI  :  10.1186/s12871-022-01963-4

 received in 2022-08-19, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundUltrasound-guided low interscalene brachial plexus block (LISB) can provide satisfactory anesthesia for surgery at or below the elbow. However, the anesthesia effect of ultrasound-guided middle interscalene brachial plexus block (MISB) has not been fully investigated. We hypothesized that MISB provides a non-inferior anesthesia effect to LISB for surgery at or below the elbow.MethodsA total of 82 patients with ASA I-III (18–65 years) scheduled for elective surgery at or below the elbow were randomized to the MISB group or the LISB group equally, located 1/2 or 2/3 of the caudal distance from C6 to the clavicle. Both groups were administered 15 mL 0.5% ropivacaine at the lower part of the brachial plexus with the first injection and equivalent volume at the upper part with the second injection.ResultsFor the primary outcome, 92.3% in the MISB group experienced successful anesthesia compared to 94.6% in the LISB group [difference: –2.3%, 95% confidence interval (CI) –13.4% to 8.8%], exceeding the predefined non-inferiority margin -15%. For the secondary outcomes, the incidence of pleura suppression for the first injection (7.7% vs. 45.9%, P < 0.001) and the time to perform the block (9.9 ± 1.3 vs. 10.7 ± 1.3 min, P = 0.006) were significantly less in MISB compared to LISB. No significant differences were observed in the consumption of perioperative rescue analgesics, VAS score, and adverse events within the two groups.ConclusionsMISB provides a non-inferior anesthesia effect to LISB for surgery at or below the elbow.Trial registrationChinese Clinical Trial Register (identifier: ChiCTR2100054196).

【 授权许可】

CC BY   
© The Author(s) 2022

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