Comparison of sensorial and motor block quality between axillary and infraclavicular approaches for brachial plexus block during arteriovenous fistula operations

97SUMMARYPlexus brachialis block can be performed with different approaches. In this study weaimed to compare the infraclavicular and axillary approaches in 40 consecutive patients thatwere undergone arteriovenous fistula operations for hemodialysis. Besides quality andvelocity of the block, side effects and complication rates were also evaluated. The patientswere randomly divided into two groups. Group 1 was exposed to an axillary block guided bya nerve stimulator with multiple injection technique and Group 2 an infraclavicular blockguided by a nerve stimulator with single injection technique. All blocks were performed witha mixture of equal amounts of lidocaine 2% and bupivacaine 0.5 %. Total amount of the localanesthetic solution for each patient was calculated with a formula that was based patient?sheight: volume (ml) = height (cm)/5.Duration of the blocks were recorded as a time that was started with grasping theinjector and ended with taking out injector. The quality of sensorial block was assessed withthe pinprick method by using the following scale: 0 points = pinprick perceived as a painful(no block), 1 points = analgesia; and 2 points = anesthesia to pinprick (no perception). Motorblock was also assessed for flexion and extension of the elbow, flexion and extension of thewrist and flexion and extension of the fingers, and adduction of the thumb by using thefollowing scale: 0 points = no paresis, 1 points = paresis; and 2 points = complete paralysis.Side effects and complications were also recorded.In the results, the nerves that were blocked insufficiently with axillary approach(axillary nerve, medial brachial cutaneus nerve, and intercostobrachial nerve) while the nerveswere blocked with infraclavicular approach successfully. Controversy, the quality of block forulnar and medial antebrachial cutaneus nerve was assessed as higher in the axillary block98group than infraclavicular block group. The duration of block was shorter in infraclavicularblock group than axillary block group. There were no differences for complication and sideeffect rates in the both groups.In conclusion, single injection for brachial plexus block via infraclavicular approachshould be taken into consideration as an alternative to axillary brachial block with superiorfeatures that were verified in this study.