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Anesth Analg 2009; 108:1967-1970
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181a2a252
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ANALGESIA

Does Ultrasound Guidance Improve the Success Rate of Infraclavicular Brachial Plexus Block When Compared with Nerve Stimulation in Children with Radial Club Hands?

Vrushali C. Ponde, MD, and Sandeep Diwan, MD

From the Department of Anesthesiology, All India institute of physical Medicine and Rehabilitation, Mumbai, Maharashtra, India.

Address correspondence and reprint requests to Dr. Vrushali C. Ponde, Amit Apartments, 401, Veronica road, Bandra West, Mumbai 400050, Maharashtra, India. Address e-mail to vrushaliponde{at}yahoo.co.in

Abstract

BACKGROUND: The classical response to nerve stimulation may be altered in cases of radial club hand. Ultrasound guidance may prove to be a useful tool in such situations. In this study, we compared the success rate of ultrasound-guided infraclavicular brachial plexus block with nerve stimulation for children undergoing radial club hand repair.

METHODS: Fifty children, aged 1-2 yr, undergoing radial club hand repair were randomly assigned to receive infraclavicular brachial plexus block guided by nerve stimulator (Group NS) or ultrasound (Group U) in combination with light general anesthetic. Bupivacaine 0.5 mL/kg of 0.5% was injected in both groups. Pain response to surgical stimulus was considered as block failure. The Children’s Hospital Eastern Ontario Pain Scale pain score was recorded at 1, 4, 6, 8, and 10 postoperative hours.

RESULTS: In Group NS, the blocks were successful in 16 of 25 patients (64%), whereas in Group U, 24 of 25 patients had successful blocks (P = 0.0053). There was no difference in the time to first analgesia or analgesic consumption in the 10-h study period.

CONCLUSION: Ultrasound-guided infraclavicular brachial plexus block improves the success rate in patients with radial club hands when compared with nerve stimulation in patients undergoing radial club hand correction.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.