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COMPARISON OF THE AXILLARY AND THE SUPRACLAVICULAR PLEXUS BLOCK REGARDING DIAPHRAGMATIC MOVEMENT AND SPIROMETRY
ESRA Academy. Gorsewski G. Sep 9, 2016; 138540; 0408 Topic: Safety of Regional Anaesthesia - Complications - General Aspects
Dr. Gernot Gorsewski
Dr. Gernot Gorsewski

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Abstract
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Background and Aims:

Ultrasound-guided regional anaesthesia, particularly axillary (AXB) and supraclavicular blocks (SCB) are widely established procedures used in an ambulatory setting. The aim of this study was to compare the disadvantageous side effects e.g. decreased diaphragmatic movement or decline in spirometric parameters after AXB or SCB.

Methods:

After ethics committee’s approval 140 patients were randomized to either AXB (n = 70) or SCB (n = 70) right before going to surgery. Patients were examined both before and after surgery regarding changes in spirometry (FVC, FEV1, PEF) and alteration in diaphragmatic movement detected by ultrasound.

Results:

The data showed a noticeable but non-significant change in diaphragmatic movement during normal ventilation. Under forced ventilation the movement range in the SCB group dropped by 11.8% whereas a slight increase of 1.8% was measured in the AXB group. 24.2% (warum steht in der Diss 19,4%?) of subjects in the SCB group showed a reduction in forced diaphragmatic movement over 25%. In 4.8% of subjects the loss exceeded even 75%, classified as a full paresis. By contrast only 4.4% in AXB group showed a loss more than 25% and none over 75%.Regarding spirometry parameters FVC, FEV1 and PEF the SCB showed a significant reduction of -8,7%, -12,7% and -12,9% respectively, whereas the axillary block was accompanied with almost no change (-0.6%, -2.3%, -0.7%).

Conclusions:

Although both approaches provide sufficient anaesthesia the AXB affected diaphragmatic movement and spirometry parameters less than the SCB.

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