Andrea Wenger1, Jens Rothenberger2, Lara-Elena Hakim-Meibodi3, Thomas Notheisen4, Hans-Eberhard Schaller2. 1. Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wurttemberg, Germany. Electronic address: awenger@bgu-tuebingen.de. 2. Clinic for Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wurttemberg, Germany. 3. Medical Faculty, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wurttemberg, Germany. 4. Clinic for Anaesthesia, Intensive Care and Pain Therapy, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wurttemberg, Germany.
Abstract
BACKGROUND: Axillary plexus block is a common method for regional anesthesia, especially in hand and wrist surgery. Local anesthetics (e.g., mepivacaine) are injected around the peripheral nerves in the axilla. A vasodilatory effect due to sympathicolysis has been described, but not quantified. MATERIALS AND METHODS: In a prospective controlled study between October 2012 and July 2013, we analyzed 20 patients with saddle joint arthritis undergoing trapeziectomy under axillary plexus block. Patients received a mixture of mepivacaine 1% and ropivacaine 0.75% in a 3:1 ratio. The measurements were carried out on the plexus side and the contralateral hand, which acted as the control. Laser-Doppler spectrophotometry (oxygen to see [O2C] device) was used to measure various perfusion factors before and after the plexus block, after surgery and in 2-h intervals until 6 h postoperatively. RESULTS: Compared with the contralateral side, the plexus block produced an enhancement of tissue oxygen saturation of 117.35 ± 34.99% (cf. control SO2: 92.92 ± 22.30%, P < 0.010) of the baseline value. Furthermore, blood filling of microvessels (rHb: 131.36 ± 48.64% versus 109.12 ± 33.25%, P < 0.0062), peripheral blood flow (219.85 ± 165.59% versus 129.55 ± 77.12%, P < 0.018), and velocity (163.86 ± 58.18% versus 117.16 ± 45.05%, P < 0.006) showed an increase of values. CONCLUSIONS: Axillary plexus block produces an improvement of peripheral tissue oxygen saturation of the upper extremity over the first 4 h after the inception of anesthesia.
BACKGROUND: Axillary plexus block is a common method for regional anesthesia, especially in hand and wrist surgery. Local anesthetics (e.g., mepivacaine) are injected around the peripheral nerves in the axilla. A vasodilatory effect due to sympathicolysis has been described, but not quantified. MATERIALS AND METHODS: In a prospective controlled study between October 2012 and July 2013, we analyzed 20 patients with saddle joint arthritis undergoing trapeziectomy under axillary plexus block. Patients received a mixture of mepivacaine 1% and ropivacaine 0.75% in a 3:1 ratio. The measurements were carried out on the plexus side and the contralateral hand, which acted as the control. Laser-Doppler spectrophotometry (oxygen to see [O2C] device) was used to measure various perfusion factors before and after the plexus block, after surgery and in 2-h intervals until 6 h postoperatively. RESULTS: Compared with the contralateral side, the plexus block produced an enhancement of tissue oxygen saturation of 117.35 ± 34.99% (cf. control SO2: 92.92 ± 22.30%, P < 0.010) of the baseline value. Furthermore, blood filling of microvessels (rHb: 131.36 ± 48.64% versus 109.12 ± 33.25%, P < 0.0062), peripheral blood flow (219.85 ± 165.59% versus 129.55 ± 77.12%, P < 0.018), and velocity (163.86 ± 58.18% versus 117.16 ± 45.05%, P < 0.006) showed an increase of values. CONCLUSIONS: Axillary plexus block produces an improvement of peripheral tissue oxygen saturation of the upper extremity over the first 4 h after the inception of anesthesia.
Authors: Catalina I Dumitrascu; Nafisseh S Warner; Thomas M Stewart; Adam W Amundson; Danette L Bruns; Andrew C Hanson; Phillip J Schulte; Mark M Smith; Michael J Brown; Adam D Niesen; Carlos B Mantilla; Matthew A Warner Journal: Pain Pract Date: 2020-11-04 Impact factor: 3.183
Authors: Talia Bosselmann; Jonas Kolbenschlag; Ole Goertz; Peter Zahn; Lukas Prantl; Marcus Lehnhardt; Björn Behr; Alexander Sogorski Journal: J Clin Med Date: 2021-05-14 Impact factor: 4.241