腕神経叢腋窩ブロックにおけるランドマーク法と超音波ガイド法の麻酔効果の比較検討

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  • Comparison between Landmark-based and Ultrasound-guided Axillary Brachial Plexus Blocks

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In this study we compared the effectiveness of perioperative axillary brachial plexus blocks performed using either a landmarked-based (LM group, n=20) or an ultrasound-guided approach (US group, n=20). Patients in the LM group received 28ml of 1% mepivacaine around the circumference of the axillary artery located by palpation of the pulse.<br>In the US group, nerve location was performed using ultrasound. The ulnar, median, radial, and musculocutaneous nerves were each blocked separately with 7ml of 1% mepivacaine.<br>At the start of surgery, 14 patients in the LM group needed an injection of local anesthetic at the incision point, compared with 11 patients in the US group. Furthermore, 6 patients in the LM group needed intravenous pentazocin anesthesia, compared with 2 patients in the US group. The numbers of patients needing general anesthesia in order to complete the surgery were 3 in the LM group and 1 in the US group.<br>Ultrasound-guided axillary brachial plexus block may be more effective than a landmarked-based approach.

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