UNLABELLED The infraclavicular brachial plexus block first described by Raj et al. was supposed to anesthetize all the main peripheral nerves of the brachial plexus without the risk of pneumothorax. However, in performing the block, we have had difficulties finding the nerves at the cord level. Therefore, we questioned whether the recommended needle direction (the "Raj line") guides the needle ...

Local anesthetic intoxication is a medical emergency with high mortality. These drugs have not spesific antidotes, quick differential diagnosis and supportive treatment required in the case of exposure to toxic doses. We report the complications and anesthetic management of a patient who was scheduled for right carpal tunnel syndrome surgery under regional anesthesia, but mistakenly received in...

To the Editor, We read with great interest the recently reported study of Chan et al.1 This study warrants comment due to the low success rates reported after axillary brachial plexus block, despite the authors’ internationally recognized experience with these techniques. The study compared regional anesthesia of the upper limb using an ultrasound-guided (US) approach (the most expensive techni...

The mixture of 1% lidocaine and 0.2% tetracaine with 1:200,000 epinephrine, so-called "supercaine," has been used extensively for axillary brachial plexus blockade for several decades. Since the advent of bupivacaine, the supercaine mixture has fallen into relative disuse despite its record of effectiveness and safety. No studies have been done recently to evaluate quality of anesthesia, durati...

Regional blocks improve the success rate of arterionenous fistula (AVF) procedure in patient with end stage kidney disease (ESKD)1. We report one case of prolonged axillary block (BAX) in a 73 –yr woman undergoing an iterative AVF. Her preoperative kaliemia and creatinine were respectively 6.1mEq and 280mmoles per liter. Twenty milliter of 0.5% levobupivacaine were infused selectively under ult...

OBJECTIVE To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. METHODS This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to Augus...

The perivascular technique of axillary brachial plexus block results in incomplete block of radial and musculocutaneous nerves in 10-20% of patients. With the transarterial technique and a large dose of mepivacaine, success rates of 99% have been reported. We have compared the clinical efficacy of these techniques in 50 patients using 1% mepivacaine 45 ml with adrenaline. If required, the block...