AXILLARY BRACHIAL-PLEXUS BLOCK - DURATION OF SENSORY AND MOTOR BLOCKADE FOLLOWING 1-PERCENT MEPIVACAINE

Objectives: To assess the duration of both sensory and motor blockade of brachial plexus with 40 mL 1% mepivacaine after axillary or midhume ral approach. Study design: Prospective, open, non-comparative, multic entric study. Patients: One hundred and eighty patients, ASA physical class 1 and 2, scheduled for hand or forearm surgery under brachial pl exus block were included. Methods: A midhumeral or axillary brachial p lexus block using a nerve stimulator was performed with 40 mt of 1% me pivacaine. Sensory blockade was tested for each cutaneous area (median , radial, ulnar, musculocutaneous and medial cutaneous nerve of the fo rearm) using pin-prick. Motor blockade was assessed by grip strengh of the hand. Incidence and duration of analgesia, anaesthesia and motor blockade were assessed. The incidence of tourniquet pain and the time when pain occurred were determined. Results: According to the nerve ar ea tested, analgesia and anaesthesia were obtained in 98% and 85% of c ases respectively; duration of anaesthesia was between 150 +/- 40 to 1 67 +/- 49 minutes and duration of analgesia was from 184 +/- 50 to 205 +/- 51 minutes. Duration of paralysis was 144 +/- 40 minutes and dura tion of paresis was 190 +/- 51 minutes. Pain occurred in three out of 138 patients at tourniquet inflation and in six patients after complet ion of surgery. Conclusions: Mid humeral or axillary block with 40 mL of 1% mepivacaine is highly successful and provides efficient surgical anaesthesia for various surgical procedures of intermediary duration. (C) 1998 Elsevier, Paris.