The application of axillary brachial plexus block in tenolysis of flexor tendon adhesion of the fingers
Author(s): Ju Jihui, Guan Dapeng, Zhao Qiang, Zhang Guangliang, Li Xiangjun, Hou Ruixing
Pages: 289-291
Year: 2015 Issue: 4
Journal: Chinese Journal of Hand Surgery
Keyword: Brachial plexus; Sensation; Motion; Tendon; Adhesion;
Abstract: Objective To evaluate the clinical value of applying brachial plexus block with motor and sensory separation in flexor tenolysis of the fingers.Methodds Ultrasound-guided brachial plexus block with low concentration ropivacaine through an axillary approach was applied in 36 cases with tendon adhesion from March 2008 to March 2012.Only the sensory components were blocked during the operation and flexor tenolysis was performed after anesthesia was in effect.The effectiveness of tenolysis was judged by the active motion of the finger during the operation.Results The effective rate of brachial plexus sensory block was 100％.The onset time was (11.3 ± 3.4) minutes.The block lasted for an average of (85.7 ± 13.6) minutes.Modified Bromage method was used to assess the effect of motor block and revealed 33 cases of Grade 0 to 1,2 cases of Grade 5,and 1 case of Grade 4 blockade.The duration of the operation ranged from 30 to 90 minutes with an average of 50 minutes.Intraoperative pain was assessed on the visual analog scale (VAS),and was 0 in 30 cases and 1 to 2 in 5 cases.One case needed additional anesthesia in order to complete the operation.Overall anaesthesia effect was satisfactory.The active flexion of the finger was satisfactory in 33 cases indicating complete release of the tendon.Active finger flexion was unsatisfactory in 3 cases.Condusion Brachial plexus block with only sensory blockade allows intraoperative assessment of the effect of flexor tenolysis which is useful information for the surgeon.
Pages: 289-291
Year: 2015 Issue: 4
Journal: Chinese Journal of Hand Surgery
Keyword: Brachial plexus; Sensation; Motion; Tendon; Adhesion;
Abstract: Objective To evaluate the clinical value of applying brachial plexus block with motor and sensory separation in flexor tenolysis of the fingers.Methodds Ultrasound-guided brachial plexus block with low concentration ropivacaine through an axillary approach was applied in 36 cases with tendon adhesion from March 2008 to March 2012.Only the sensory components were blocked during the operation and flexor tenolysis was performed after anesthesia was in effect.The effectiveness of tenolysis was judged by the active motion of the finger during the operation.Results The effective rate of brachial plexus sensory block was 100％.The onset time was (11.3 ± 3.4) minutes.The block lasted for an average of (85.7 ± 13.6) minutes.Modified Bromage method was used to assess the effect of motor block and revealed 33 cases of Grade 0 to 1,2 cases of Grade 5,and 1 case of Grade 4 blockade.The duration of the operation ranged from 30 to 90 minutes with an average of 50 minutes.Intraoperative pain was assessed on the visual analog scale (VAS),and was 0 in 30 cases and 1 to 2 in 5 cases.One case needed additional anesthesia in order to complete the operation.Overall anaesthesia effect was satisfactory.The active flexion of the finger was satisfactory in 33 cases indicating complete release of the tendon.Active finger flexion was unsatisfactory in 3 cases.Condusion Brachial plexus block with only sensory blockade allows intraoperative assessment of the effect of flexor tenolysis which is useful information for the surgeon.
Related Articles