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Intervention Review

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Single, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults

  1. Ki Jinn Chin1,*,
  2. Helen HG Handoll2

Editorial Group: Cochrane Anaesthesia Group

Published Online: 6 JUL 2011

Assessed as up-to-date: 13 MAR 2011

DOI: 10.1002/14651858.CD003842.pub3


How to Cite

Chin KJ, Handoll HHG. Single, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD003842. DOI: 10.1002/14651858.CD003842.pub3.

Author Information

  1. 1

    University of Toronto, Department of Anesthesia, Toronto, Ontario, Canada

  2. 2

    Teesside University, Health and Social Care Institute, Middlesborough, Tees Valley, UK

*Ki Jinn Chin, Department of Anesthesia, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada. gasgenie@yahoo.co.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 6 JUL 2011

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This is not the most recent version of the article. View current version (02 SEP 2016)

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Baranowski 1990 {published data only}
Coventry 2001 {published data only}
  • Coventry DM. Personal communication October 13 2004.
  • Coventry DM, Barker KF, Thomson M. Comparison of two neurostimulation techniques for axillary brachial plexus block. British Journal of Anaesthesia 2001;86(1):80-3. [MEDLINE: 21459214]
Goldberg 1987 {published data only}
Hickey 1993 {published data only}
  • Hickey R, Hoffman J, Tingle LJ, Rogers JN, Ramamurthy S, Hickey R, et al. Comparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block. Regional Anesthesia 1993;18(6):335-8.
Imbelloni 2005 {published data only}
  • Geier KO. Radiological evaluation of the spread of different local anesthetic volumes during posterior brachial plexus block. Revista Brasileira de Anestesiologia  2006;56(2):202-3. [MEDLINE: 19468641]
  • Imbelloni LE, Beato L, Cordeiro JA. Comparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine. Revista Brasileira de Anestesiologia 2005;55(1):40-9. [MEDLINE: 19471807]
Inberg 1999 {published and unpublished data}
  • Annila P. Personal communication December 21 2004.
  • Inberg P, Annila I, Annila P. Double-injection method using peripheral nerve stimulator is superior to single injection in axillary plexus block. Regional Anesthesia and Pain Medicine 1999;24(6):509-13. [MEDLINE: 20053774]
K-Nielsen 1997 {published data only}
  • Koscielniak-Nielsen ZJ. Axillary block of the brachial plexus by single, double or multiple injection techniques [dissertation]. Copenhagen: University of Copenhagen, 2000.
  • Koscielniak-Nielsen ZJ. Personal communication November 11 2004.
  • Koscielniak-Nielsen ZJ, Stens-Pedersen HL, Lippert FK. Readiness for surgery after axillary block: single or multiple injection techniques. European Journal of Anaesthesiology 1997;14(2):164-71. [MEDLINE: 1997244004]
K-Nielsen 1998 {published and unpublished data}
  • Koscielniak-Nielsen ZJ. Axillary block of the brachial plexus by single, double or multiple injection techniques [dissertation]. Copenhagen: University of Copenhagen, 2000.
  • Koscielniak-Nielsen ZJ. Personal communication November 15 2004.
  • Koscielniak-Nielsen ZJ, Hesselbjerg L, Fejlberg V. Comparison of transarterial and multiple nerve stimulation techniques for an initial axillary block by 45 mL of mepivacaine 1% with adrenaline. Acta Anaesthesiologica Scandinavica 1998;42(5):570-5. [MEDLINE: 1998266411]
K-Nielsen 1999a {published and unpublished data}
  • Koscielniak-Nielsen ZJ. Axillary block of the brachial plexus by single, double or multiple injection techniques [dissertation]. Copenhagen: University of Copenhagen, 2000.
  • Koscielniak-Nielsen ZJ. Personal communication December 2 2004.
  • Koscielniak-Nielsen ZJ, Nielsen PR, Nielsen SL, Gardi-T, Hermann C. Comparison of transarterial and multiple nerve stimulation techniques for axillary block using a high dose of mepivacaine with adrenaline. Acta Anaesthesiologica Scandinavica 1999;43(4):398-404. [MEDLINE: 1999241583]
K-Nielsen 1999b {published and unpublished data}
  • Coleman MM, Day F. Axillary blockade by the targeted method. Added benefit?. Canadian Journal of Anaesthesia 2000;47(2):192-3. [MEDLINE: 10674519]
  • Koscielniak-Nielsen ZJ. Axillary block of the brachial plexus by single, double or multiple injection techniques [dissertation]. Copenhagen: University of Copenhagen, 2000.
  • Koscielniak-Nielsen ZJ. Personal communication December 14 2004.
  • Koscielniak-Nielsen ZJ, Rotboll Nielsen P, Sorensen T, Stenor M. Low dose axillary block by targeted injections of the terminal nerves. Canadian Journal of Anaesthesia 1999;46(7):658-64. [MEDLINE: 99369591]
Lavoie 1992 {published and unpublished data}
Pere 1993 {published and unpublished data}
  • Pere P. Personal communication February 2 2005.
  • Pere P, Pitkanen M, Tuominen M, Edgren J, Rosenberg PH. Clinical and radiological comparison of perivascular and transarterial techniques of axillary brachial plexus block. British Journal of Anaesthesia 1993;70(3):276-9. [MEDLINE: 1993229180]
Rodriguez 2005 {published data only}
Rodriguez 2008 {published data only}
  • Rodriguez J, Taboada M, Oliveira J, Ulloa B, Bascuas B, Alvarez J, et al. Radial plus musculocutaneous nerve stimulation for axillary block is inferior to triple nerve stimulation with 2% mepivacaine. Journal of Clinical Anesthesia 2008;20(4):253-6. [MEDLINE: 18617121]
Serradell Catalan 2001 {published and unpublished data}
  • Serradell Catalan A. Personal communication February 3 2005.
  • Serradell Catalan A, Moncho Rodriguez JM, Santos Carnes JA, Herrero Carbo R, Villanueva Ferrer JA, Masdeu Castellvi J. Axillary brachial plexus anesthesia. How many nerve stimulation responses do we look for? [Anestesia de plexo braquial por via axilar. Cuantas respuestas buscamos con neuroestimulacion?]. Revista Espanola de Anestesiologia y Reanimacion 2001;48(8):356-63. [MEDLINE: 21533027]
Sia 2001 {published data only}
  • Sia S, Lepri A, Ponzecchi P. Axillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection techniques. Regional Anesthesia and Pain Medicine 2001;26(6):499-503. [MEDLINE: 21564506]
Sia 2010a {published data only}
  • Sia S, Lepri A, Marchi M. Axillary block by "selective" injections at the nerves involved in surgery using a peripheral nerve stimulator: a comparison with a "standard" triple-injection technique. Regional Anesthesia and Pain Medicine 2010;35(1):22-7. [MEDLINE: 20052813]
Sia 2010b {published data only}
  • Sia S, Lepri A, Marchi M. Axillary block by "selective" injections at the nerves involved in surgery using a peripheral nerve stimulator: a comparison with a "standard" triple-injection technique. Regional Anesthesia and Pain Medicine 2010;35(1):22-7. [MEDLINE: 20052813]
Sia 2010c {published data only}
  • Sia S, Lepri A, Marchi M. Axillary block by "selective" injections at the nerves involved in surgery using a peripheral nerve stimulator: a comparison with a "standard" triple-injection technique. Regional Anesthesia and Pain Medicine 2010;35(1):22-7. [MEDLINE: 20052813]
Turkan 2002 {published data only}
  • Turkan H, Baykal B, Ozisik T. Axillary brachial plexus blockade: an evaluation of three techniques. Military Medicine 2002;167(9):723-5. [: 0026-4075]

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Bloc 2010 {published data only}
  • Bloc S, Mercadal L, Garnier T, Komly B, Leclerc P, Morel B, et al. Comfort of the patient during axillary blocks placement: a randomized comparison of the neurostimulation and the ultrasound guidance techniques. European Journal of Anaesthesiology 2010;27(7):628-33.
Bouaziz 1997 {published data only}
  • Bouaziz H, Narchi P, Mercier FJ, Labaille T, Zerrouk N, Girod J, et al. Comparison between conventional axillary block and a new approach at the midhumeral level. Anesthesia & Analgesia 1997;84(5):1058. [: PubMed: 9141931]
Carre 2000 {published data only}
Gianesello 2010 {published data only}
  • Gianesello L, Pavoni V, Coppini R, Buoninsegni LT, Gori G, Mori E, et al. Comfort and satisfaction during axillary brachial plexus block in trauma patients: comparison of techniques. Journal of Clinical Anesthesia 2010;22(1):7-12.
Imasogie 2010 {published data only}
  • Imasogie N, Ganapathy S, Singh S, Armstrong K, Armstrong P. A prospective, randomized, double-blind comparison of ultrasound-guided axillary brachial plexus blocks using 2 versus 4 injections. Anesthesia & Analgesia 2010;110(4):1222-6.
K-Nielsen 2000 {published data only}
Kjelstrup 2006 {published data only}
Liu 2005 {published data only}
  • Liu FC, Liou JT, Tsai YF, Li AH, Day YY, Hui YL, et al. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method. Chang Gung Medical Journal 2005;28(6):396-402. [MEDLINE: 16124155]
Sia 2001b {published data only}
Singelyn 1992 {published data only}
  • Singelyn FJ, Dangoisse M, Bartholomee S, Gouverneur JM. Adding clonidine to mepivacaine prolongs the duration of anesthesia and analgesia after axillary brachial plexus block. Regional Anesthesia 1992;17(3):148-50. [MEDLINE: 1606097]
Sites 2006 {published data only}
Tuominen 1987 {published data only}
Vester-Andersen 1984 {published data only}
Vester-Andersen 1986 {published data only}
Youssef 1988 {published data only}
Yu 2007 {published data only}
  • Yu W-P, Xu X-Z, Wu D-Z, Guo X-Y, Huang P-T. Efficacy of axillary approach brachial plexus blocking by ultrasound-guided four points via one-puncture technique. National Medical Journal of China 2007;87(11):740-5. [MEDLINE: 17565841]

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Ramirez-Gomez 2010 {published data only}
  • Ramirez-Gomez M, Schlufter-Stolberg R, Resendiz-Vargas S. Axillary brachial plexus block. Single or multiple neuro-stimulation response. [Bloque del plexo braquial via axilar. Respuesta única o múltiple por neuroestimulación]. Revista Mexicana De Anestesiologia 2010;33(1):9-16.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Altman 2003
Burnham 1958
Coventry 2001a
De Jong 1961
Fanelli 1999
  • Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Anesthesia & Analgesia 1999;88(4):847-52.
Geier 2006
  • Geier KO. Radiological evaluation of the spread of different local anesthetic volumes during posterior brachial plexus block. Revista Brasileira de Anestesiologia  2006;56(2):202-3.
Higgins 2003
Higgins 2009
  • Higgins JPT, Green S, editors. Chapter 8: Assessing risk of bias in included studies. table 8.5a. The Cochrane Collaboration's tool for assessing risk of bias. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1 (updated March 2011). The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
K-Nielsen 1997a
K-Nielsen 1998a
K-Nielsen 1999c
Lassale 1984
  • Lassale B, Ang ET. Particularités de l`organisation du tissus celluleux de la cavité axillaire. Bulletin. Societe de Chirurgie de Paris 1984;9:57-60.
Lavoie 1992a
Partridge 1987
RevMan 5.1
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Sia 2001a
  • Sia S, Lepri A, Ponzecchi P. Axillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection techniques. Regional Anesthesia and Pain Medicine 2001;26(6):499-503. [MEDLINE: 21564506]
Stan 1995
  • Stan TC, Krantz MA, Solomon DL, Poulos JG, Chaouki K. The incidence of neurovascular complications following axillary brachial plexus block using a transarterial approach. A prospective study of 1000 consecutive patients. Regional Anesthesia 1995;20:486-92.
Thompson 1983
Urban 1994
Vester-Andersen 1984a
Vester-Andersen 1984b
Vester-Andersen 1986a

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Handoll 2006
  • Handoll HHG, Koscielniak-Nielsen ZJ. Single, double or multiple injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery. Cochrane Database of Systematic Reviews 2006, Issue 1. [DOI: 10.1002/14651858.CD003842.pub2]