Ultrasound-guided Parasagittal Infraclavicular Block for Patients without Neurostimulation Endpoints: A Case Report in Crush Injuries of the Upper Limb

超声引导下锁骨下旁矢状神经阻滞治疗无神经刺激终点的患者:上肢挤压伤病例报告

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Abstract

Evoked motor responses (distal muscle responses) to a specific nerve stimulation are considered an endpoint. Often in crush injuries of the upper limb below the level of the elbow, the distal muscle responses are irrelevant. We report 14 cases of crush injuries of the upper limb that underwent an amputation below the level of the elbow. A parasagittal ultrasound-guided infraclavicular block without neurostimulation was administered in all patients. A reliable local anesthetic (LA) spread either in the perineural or perivascular area is considered adequate. Adequate intraoperative anesthesia and postoperative analgesia were achieved with the deposition of LA beneath the axillary artery.

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