Comparison of the Efficacy of Different Local Anesthetic Volumes on the Success of Combined Interscalene-Supraclavicular Nerve Block Farklı Lokal Anestetik Hacimlerinin Kombine İnterskalen-Supraklavikular Sinir Bloğunun Başarısına Olan Etkinliklerinin Karşılaştırılması
Medical Journal of Bakirkoy, cilt.21, sa.1, ss.104-111, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/bmj.galenos.2024.2024.8-1
- Dergi Adı: Medical Journal of Bakirkoy
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.104-111
- Anahtar Kelimeler: Upper extremity, interscalene block, supraclavicular block, low volume local anesthetic
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Brachial plexus blocks are used as an alternative to general anesthesia for most procedures performed in the upper extremity. This study aimed to compare the perioperative anesthetic and analgesic efficacy of combined interscalene block-supraclavicular brachial plexus block (ISB+SCB), with different volumes of local anesthetic (LA) under ultrasound guidance. Methods: Data from 85 patients who underwent ISB+SCB for anesthesia in proximal upper extremity surgery including unilateral humerus and shoulder procedures between March 2021 and September 2023 were retrospectively reviewed. According to the local anaesthetic volume of bupivacaine administered, the patients were divided into two groups: the high volume group (Group H), with 18 mL or more, and the low volume group (Group L), with less than 18 mL. Patients were evaluated in terms of anesthetic and analgesic effects in the perioperative period. Results: Postoperative pain scores and additional analgesic requirements were not significantly different between the two groups during the follow-up period. Motor block was terminated in all patients (100%) at the 8th postoperative hour in Group L, whereas the rate was 89.4% in Group H. A statistically significant difference was found between the two groups (p=0.047). In Group H, the resolution of motor block in all patients was determined at the 12th postoperative hour. The volume of LA given in both groups was sufficient for surgical anesthesia. Conclusion: Ultrasound-guided ISB+SCB with lower LA volume may provide effective surgical anesthesia and analgesia with similar efficacy and shorter duration of motor block in shoulder and humerus surgery.