Cuenca DJ, Herrera CL, Pérez PA

Language: Spanish
References: 12
Page: 7-10
PDF size: 632.53 Kb.

ABSTRACT

Objective: To compare the efficiency of three anesthetic techniques for the brachial plexus block (supraclavicular approach. axillary block and cervical epidural anesthesia), for upper extremity surgical procedures. Material and Methods: This is a randomized, time-course followed. prospective. and comparative study, in which 76 ASA UlB and UIIB patients were included, and were under surgery from upper extremities. The patients were distributed in three groups according to the brachial plexus block approach. Group A: cervical epidural anesthesia, group B: supraclavicular approach and group C: axillary block. Same preanesthetic medications were administered for all patients. Patients in group A. received lidocaine 2% with epinephrine (200 mg). for the first dose, and bupivacaine 0.5%, (50 mg), for the following doses. Patients in group Group B y C received lidocaine 2% (400 mg), and bupivacaine 5% (50 mg), in bidestilled water respectively. Population characteristics, latency time, anesthetic time, surgery time. mean blood pressure, heart rate, pulse oximetry, and anesthesia/analgesia quality were compared between the groups. Results: Patients in Group A showed the longest latency time (10 ± 3 minutes), followed for the patients in group B (6 ± 1.5 min) and the patients in group C (5 ± 2.3 min, p ‹ 0.05). Surgical time was 4.4 ± 1.30 hours in group A patients, 3.2 ± 1.2 hours in group B patients), and 3.4 ± 1.3 hours in the group patients (p ‹ 0.05). Anesthesia time was 5.3 ± 1.6 hours in group A patients, 4.2 ± 1.2 hours in group B and 4.4 ± 1.4 hours in group C patients (p ‹ 0.05). During surgery and in the postoperative period, hemodynamic variables did not show any statistically significative difference between patients from the same group, and those from different groups. One hundred percent of the patients in group A evaluated the anesthesia/analgesia as excellent. Conclusions: The three approaches for the brachial plexus block are safe and efficient; nevertheless, cervical epidural anesthesia resulted in a longer latency, duration, and a better qualification by the patients.

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