"Comparison of the anesthesia effect of ultrasound-guided middle and low interscalene brachial plexus block: a randomized, controlled, non-inferiority trial"

作者全名："Zhao, Yang; Qin, Shiming; Yang, Xue; Gao, Chongmei; Yuan, Xia; Li, Tao; Chen, Zhaohui"

作者地址："[Zhao, Yang] North Sichuan Med Coll, Dept Anesthesiol, Affiliated Hosp, 1 South Maoyuan Rd, Nanchong 637000, Sichuan, Peoples R China; [Zhao, Yang] Guangxi Med Univ, Dept Anesthesiol, Affiliated Hosp 1, 22 Shuangyong Rd, Nanning 530021, Guangxi, Peoples R China; [Qin, Shiming; Yang, Xue; Gao, Chongmei; Yuan, Xia; Chen, Zhaohui] Chongqing Med Univ, Gener Hosp, Dept Anesthesiol, Affiliated Hosp 3, 1 Shuanghu Branch Rd, Chongqing 401120, Peoples R China; [Li, Tao] Chengdu Second Peoples Hosp, Dept Radiol, Chengdu 610017, Sichuan, Peoples R China"

通信作者："Chen, ZH (通讯作者)，Chongqing Med Univ, Gener Hosp, Dept Anesthesiol, Affiliated Hosp 3, 1 Shuanghu Branch Rd, Chongqing 401120, Peoples R China."

来源：BMC ANESTHESIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000906887800001

JCR分区：Q2

影响因子：2.2

年份：2023

卷号：23

期号：1

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结束页：　

文献类型：Article

关键词：Block; Brachial Plexus; Methods; Anesthesia; Ultrasonography; Elbow

摘要："Background: Ultrasound-guided low interscalene brachial plexus block (LISB) can provide satisfactory anesthesia for surgery at or below the elbow. However, the anesthesia effect of ultrasound-guided middle interscalene brachial plexus block (MISB) has not been fully investigated. We hypothesized that MISB provides a non-inferior anesthesia effect to LISB for surgery at or below the elbow.Methods: A total of 82 patients with ASA I-III (18-65 years) scheduled for elective surgery at or below the elbow were randomized to the MISB group or the LISB group equally, located 1/2 or 2/3 of the caudal distance from C6 to the clavicle. Both groups were administered 15 mL 0.5% ropivacaine at the lower part of the brachial plexus with the first injection and equivalent volume at the upper part with the second injection. Results: For the primary outcome, 92.3% in the MISB group experienced successful anesthesia compared to 94.6% in the LISB group [difference: -2.3%, 95% confidence interval (CI) -13.4% to 8.8%], exceeding the predefined non inferiority margin-15%. For the secondary outcomes, the incidence of pleura suppression for the first injection (7.7% vs. 45.9%, P < 0.001) and the time to perform the block (9.9 +/- 1.3 vs. 10.7 +/- 1.3 min, P = 0.006) were significantly less in MISB compared to LISB. No significant differences were observed in the consumption of perioperative rescue analgesics, VAS score, and adverse events within the two groups.Conclusions: MISB provides a non-inferior anesthesia effect to LISB for surgery at or below the elbow."

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