Randomized comparison between ultrasound-guided proximal and distal approaches of intercostobrachial nerve block as an adjunct to supraclavicular brachial plexus block for upper arm arteriovenous access procedures
Primary resultResult — go to the resultDifference 23.3% 95% CI 6.3%–40.4%Authors' conclusion
Proximal ICBN block consistently reduced sensation in the medial upper arm and axilla, while one-quarter of distal blocks spared the axilla. Both approaches, in combination with a supraclavicular brachial plexus block, were effective for upper arm arteriovenous access procedures.
Study context
- Population
- End-stage renal disease patients undergoing upper arm arteriovenous access
- Participants
- 60 patients
- Comparison
- Proximal vs Distal
- Primary endpoint
- Successful ICBN block (cutaneous sensory blockade at both medial upper arm and axilla)
- Follow-up
- 30 min after the block
Primary result
As reported in the abstract
Difference
23.3%
95% CI 6.3%–40.4%
P = 0.03
By group
Proximal vs Distal
difference 23.3% (95% CI 6.3%–40.4%); P = 0.03
Secondary outcomes
- Sensory blockade at the axilla · 30 min after the block — Higher percentage of sensory blockade at the axilla with the proximal approach (proximal vs distal)
- 96.7% vs 73.3% · P = 0.03
- Sensory blockade at the medial upper arm · 30 min after the block — Comparable rates at the medial upper arm (proximal vs distal)
- 96.7% vs 96.7% · P = 1.00
Surgical anesthesia rate
- Similar surgical anesthesia rates in both groups
- 93.3%
Performance time, procedural pain, postoperative pain intensity
- No significant differences
Original publication
Randomized comparison between ultrasound-guided proximal and distal approaches of intercostobrachial nerve block as an adjunct to supraclavicular brachial plexus block for upper arm arteriovenous access procedures. Reg Anesth Pain Med. Published 24 October 2024. doi:10.
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