Current Issue Previous Issues Published Ahead-of-Print CME Subjects Timely Topics Translations Podcasts For Authors Journal Info
Skip Navigation LinksHome > February 2007 - Volume 104 - Issue 2 > Axillary or Humeral Block in Trauma Patients?
Anesthesia & Analgesia:
doi: 10.1213/01.ane.0000253580.71061.97
Letters to the Editor: Letters & Announcements

Axillary or Humeral Block in Trauma Patients?

Koscielniak-Nielsen, Zbigniew J. MD, PhD, FRCA

Section Editor(s): Saidman, Lawrence

Free Access
Article Outline
Collapse Box

Author Information

Orthopaedic Anaesthesia Unit; Rigshospital; Copenhagen; Denmark; zjkn@rh.dk

Back to Top | Article Outline

To the Editor:

Fuzier et al. (1) recently compared double-injection axillary brachial plexus block with midhumeral block for emergency surgery of the upper arm. They define secondary block effectiveness as a surgical analgesia after supplementary blocks, and report 100% secondary block effectiveness in both groups. However, their Table 2 showed 93% effectiveness in the axillary block group (80% successful primary block and 13% supplemented) and 98% effectiveness in the midhumoral group (91% successful primary block and 7% supplemented). It is not clear why these numbers do not add up to 100%.

It is also unclear why the authors concluded that a double-injection axillary block was superior to a midhumeral block. More axillary blocks needed supplementary blocks. Analgesia of the musculocutaneous nerve was significantly poorer with axillary blocks. The onset time was similar. The only advantage of axillary block was patients’ shorter performance time and higher block tolerance. As shown by Kinirons et al., (2) discomfort during block placement can be reduced with sedation.

Zbigniew J. Koscielniak-Nielsen, MD, PhD, FRCA

Orthopaedic Anaesthesia Unit

Rigshospital

Copenhagen

Denmark

zjkn@rh.dk

Back to Top | Article Outline

REFERENCES

1. Fuzier R, Fourcade O, Pianezza A, et al. A comparison between double-injection axillary brachial plexus block and midhumeral block for emergency upper limb surgery. Anesth Analg 2006;102:1856–8.

2. Kinirons BP, Bouaziz H, Paqueron X, et al. Sedation with sufentanil and midazolam decreases pain in patients undergoing upper limb surgery under multiple nerve block. Anesth Analg 2000;90:1118–21.

© 2007 International Anesthesia Research Society

Login

Become a Society Member