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Arch Hand Microsurg > Volume 24(2); 2019 > Article
Archives of Hand and Microsurgery 2019;24(2):152-161.
Published online June 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.2.152   
Ultrasound-Guided Axillary Brachial Plexus Block Performed by OIrthopedic Surgeon for Distal Radius Fracture Surgery
Doohoon Sun, Chul-Hyung Lee, Cheol-U Kim, Deukhee Jung, Chung-Han An
Department of Orthopedic Surgery, Daejeon Sun Hospital, Daejeon, Korea. mediiron@naver.com
Received: 21 January 2019   • Revised: 31 March 2019   • Accepted: 31 March 2019
Abstract
Purpose
The purpose of this study was to evaluate the usefulness of ultrasound-guided axillary brachial plexus block performed by orthopedic surgeon as an anesthetic method for distal radius fracture surgery.

Methods
From October 2017 to October 2018, an ultrasound-guided axillary brachial plexus block was performed on 161 cases of distal radius fracture requiring surgery. The procedure was performed by orthopedic surgeons using solution (20 mL of lidocaine HCl in 2%, 20 mL of ropivacaine in 0.75%, and 10 mL of normal saline in 0.9%). The success rate of the anesthetic procedure, the duration of analgesic effect, and the complications were investigated. If the anesthesia induction failed, additional local anesthetic methods were performed stepwise and reassessment about whether the operation could proceed was made.

Results
Anesthesia was successful in 155 patients and the success rate was 96.3%. The duration of analgesic effect was 6 hours (3–10 hours). In 6 failed cases of anesthesia, local anesthesia was applied to the pain site in the operating room. In 5 cases, the operation was completed without discomfort. In 1 case complaining of pain around fracture site after the local anesthesia, ultrasound-guided radial nerve block was effective in controlling the pain.

Conclusion
In open surgery of distal radius fractures, an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeon allows anesthesia with high success rates. Even if the surgical anesthesia is incomplete, it is expected that the surgery cab be completed safely if the nerve is identified and the stepwise additional local anesthesia method is performed.
Key Words: Distal radius fracture, Orthopedic surgeon, Ultrasound-guided axillary brachial plexus block, Additional anesthesia
 
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