Anesth Analg 2007;104:455
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000253567.00290.ec
LETTER TO THE EDITOR
Section Editor:
Lawrence Saidman
Axillary or Humeral Block in Trauma Patients?
Régis Fuzier, MD, and
Olivier Fourcade, PhD
Anesthésiste-Service Orthopédie; CHU Purpan; Toulouse Cedex 9, France; fuzier.r{at}chu-toulouse.fr
In Response:
Dr. Koscielniak-Nielsen (1) correctly noted that Table 2 in our study comparing double-injection axillary brachial plexus block with midhumeral block (2) is confusing. The results depend on the definition given to primary and secondary effectiveness. In the study, supplementary block at the elbow was performed only when cutaneous distribution of a nerve involved in the surgical area was missing. Six patients in Group A and three patients in Group H needed a supplementary block. Three patients in Group A and one patient in Group H did not require a supplementary block and no events were noted during the surgery. This explains why the sum between primary and supplementary block did not add up to 100%, while secondary block effectiveness reached 100% in both groups. We agree that more axillary blocks needed supplementary blocks. This mainly concerned the musculocutaneous nerve that presented a greater success rate in Group H (Table 3). As we stated in our conclusion, we consider the double-injection axillary brachial plexus block superior for emergency surgery involving the hand (and not all the upper limb) where the cutaneous distribution of the musculocutaneous nerve is not involved.
REFERENCES
- Koscielniak-Nielsen ZJ. Axillary or humeral block in trauma patients? Anesth Analg 2007;104:454.[Free Full Text]
- Fuzier R, Fourcade O, Pianezza A, et al. A comparison between double-injection axillary brachial plexus block and midhumeral block for emergency upper limb surgery. Anesth Analg 2006;102:1856–8.[Abstract/Free Full Text]
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