| Clinical Evaluation of Supraclavicular Block ; Influence of Injected Volume of Bupivacaine on Neural Blockade. |
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Youngdae Kim, Inho Um, Hongsik Lee, Gunsun Shin, Pilgon Kim |
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Department of Anesthesiology, Sung Ae Hospital, Seoul, Korea. |
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| Abstract |
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Brachial plexus block is frequently used for surgery on the upper extremity. Unsuccessful brachial plexus block is usually caused either by injection outside the neurovascular sheath or by incomplete blockade inspite of injection within the neurovascular sheath. Studied by Winnie and Collines suggested that the extent of blockade following injection in the sheath surrounding the brachial plexus also should be directly proportional to the volume of local anesthetic injected. We therefore investigated the extent of blockade using different volume of bupivacaine with supraclavicular approach. The results were as follows. 1) Complete analgesia was observed between the group of 15 ml and 30 ml. 2) The interval of complaint of pain after a single injection ranged from 14.3 to 16.4 hours. Insignifi-cant difference was found between the group of 15 ml and 30 ml (p> 0.1) 3) There was no hematoma, shivering, but there was Horner's syndrome in 13, phrenic N.paralysis in 2, pneumothorax in 1 cases. No general seizure or other side effects were observed. Therefore we come to the conclusion that above the volume of 15 ml is sufficient to brachial plexus block with supraclavicular approach. |
| Key Words:
Supraclavicular approach; Bupivacaine; Volume of injection |
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