Pain practice : the official journal of World Institute of Pain
-
It has been suggested that performing a nerve block under general anesthesia, as customary in pediatric population, may predispose to nerve injury. However, few clinical data exist to either support or refute this assertion. ⋯ Definitive conclusions cannot be drawn because of disparities in patient group demographics (majority of pediatric patients were in the general anesthesia group) and the retrospective nature of this study. Nevertheless, the findings suggest that the conduct of axillary block under general anesthesia in pediatric patients holds a greater potential for nerve injury than when the block is performed under sedation in adults.
-
The infraclavicular approach to the brachial plexus is a safe and reliable technique for surgery of the upper extremity. When performing the block, the anesthesiologist must appreciate three variables: needle direction, needle angle to the chest wall, and needle depth. Surface stimulation is an easy technique that can reliably predict both needle direction and needle angle.