• Anesthesia and analgesia · Apr 2014

    Randomized Controlled Trial Comparative Study

    A comparison of posterior and medial cord stimulation for neurostimulation-guided vertical infraclavicular block: a randomized noninferiority clinical trial.

    • Chun Woo Yang, Sung Mee Jung, Hee Uk Kwon, Po Soon Kang, Choon Kyu Cho, Jin Young Oh, Younsuk Lee, and Junghee Choi.
    • From the *Department of Anesthesiology and Pain Medicine, Cheju Halla General Hospital, Jeju-si, Jeju special self-governing province; †Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, Daegu; ‡Department of Anesthesiology and Pain Medicine, Konyang university hospital, Daejeon; §Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang; and ‖Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
    • Anesth. Analg.. 2014 Apr 1;118(4):874-8.

    BackgroundWe investigated whether medial cord stimulation is inferior to posterior cord stimulation for vertical infraclavicular block with respect to block success.MethodsNinety-six patients scheduled for upper limb surgery were randomly elicited a medial or posterior cord response for infraclavicular block using 40 mL of 0.5% ropivacaine. We assessed block success (complete sensory block of the 5 nerves in the forearm at 50 minutes) as the primary end point and block procedure characteristics and adverse events as secondary end points.ResultsThe block success rates did not differ significantly between medial and posterior cord stimulation (95.7% [44/46] vs 91.7% [44/48], 95% CI of difference, -7.4% to 15.6%), while the secondary end points were comparable in both groups.ConclusionsNeedle manipulation to elicit medial cord response is noninferior to posterior cord response of block success during neurostimulation-guided vertical infraclavicular block.

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