The road to success: a review of 1000 axillary brachial plexus blocks.

The authors present their experience of > 1000 axillary brachial plexus blocks performed over 13 years (1990-2002). Using a technique that involves the location of individual nerves with a nerve stimulator, the overall success rate was 97.9%, ranging from 89.7% in 1990 to 98.4% in 1998. There have been no failures, defined as the need for conversion to general anaesthesia, in the last 500 blocks. Supplementary nerve blocks at the elbow were performed in 22.2% of patients. The first author, trained and supervised by the second author, achieved similar success rates in half the time taken by the second author. The authors conclude that technique and experience are the keys to success, but that high success rates can be achieved in a short time if anaesthetists are trained by experts in regional anaesthesia.