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Anesth Analg 2008; 107:1075-1078
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31817ef259
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REGIONAL ANESTHESIA

A Comparison Between Ultrasound-Guided Infraclavicular Block Using the "Double Bubble" Sign and Neurostimulation-Guided Axillary Block

De Q. H. Tran, MD, FRCPC, Antonio Clemente, MD, Don Q. Tran, MD, and Roderick J. Finlayson, MD, FRCPC

From the Montreal General Hospital, Department of Anesthesia; McGill University, Montreal, Quebec, Canada.

Address correspondence and reprint requests to De QH Tran, MD, FRCPC, Montreal General Hospital, Department of Anesthesia, 1650 Ave. Cedar, D10-144, Montreal, Quebec, Canada H3G-1A4. Address e-mail to de_tran{at}hotmail.com.

BACKGROUND: Ultrasound-guided infraclavicular block can be performed using the double bubble sign. Previously described, the double bubble sign consists superiorly of the axillary artery (in short axis) superimposed on an inferior bubble created by local anesthetic injection. In this study, we compared this new method of brachial plexus anesthesia to the traditional triple-nerve stimulation axillary block.

METHODS: Seventy patients were randomized to receive a single-injection, ultrasound-guided infraclavicular block using the double bubble sign or a triple-stimulation axillary block.

RESULTS: Both methods produced similar success rates (89%–91%). However, infraclavicular blocks were associated with a shorter performance time (3.90 ± 2.27 vs 8.03 ± 3.92 min; P < 0.001) and lower block-related pain scores (2.70 ± 2.02 vs 4.17 ± 2.57 on a 0–10 scale; P = 0.01).

CONCLUSION: Compared to triple-stimulation axillary block, ultrasound-guided infraclavicular block using the double bubble sign provided a similar efficacy, a shorter performance time and lower procedural pain scores.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.