Anesthesiology
doi: 10.25005/2074-0581-2023-25-4-562-570
PROLONGED BRACHIAL PLEXUS BLOCKADE FOR UPPER LIMB SURGERY

O.N. YAMSHCHIKOV1,2, A.P. MARCHENKO1,2, S.A. EMELYANOV1,2, O.D. IVANOVA3, R.A. MARCHENKO4, S.A. IGNATOVA1

1Derzhavin Tambov State University, Medical Institute, Tambov, Russian Federation
2City Clinical Hospital of Kotovsk, Kotovsk, Russian Federation
3I.S. Dolgushin City Clinical Hospital № 3, Tambov, Russian Federation
4National Medical Research Center for High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky, village Novyy, Moscow region, Russian Federation

Methods: This article overviews the various prolonged plexus block (PB) methods. It discusses the indications and contraindications for this technique and the professional skills and equipment needed. The article also describes different approaches to a brachial plexus block (BPB): interscalene, supraclavicular, infraclavicular, and axillary. The article presents the rationale for using PB, its advantages and possible complications, and outlines the basic principles for its safe performance. Knowledge of anatomical and topographic landmarks, ultrasound navigation, and neurostimulation are utilized to determine needle position. Neurostimulation should be used to ensure the needle is placed correctly to achieve a muscle response with a current of 0.3-0.5 mA. A muscle response with a current of 0.2 mA occurs only when the needle tip is positioned intraneurally, which is unacceptable when performing plexus and nerve conduction blocks. This technique can provide prolonged anesthesia and postoperative pain relief by correctly and safely blocking nerve plexuses and trunks. It is an ideal option for anaesthesiologic support during surgical interventions and treating postoperative pain. This approach has many advantages and does not have the disadvantages associated with other types of local and general anesthesia. In this literature review, we used databases such as eLIBRARY, PubMed, and Google Scholar to search for articles related to regional anesthesia, specifically, BPB. We narrowed our search by using keywords including ultrasound navigation, neurostimulation, and catheter-based techniques.

Keywords: Brachial plexus, regional anesthesia, prolonged plexus block, ultrasound navigation, neurostimulation, catheter-based techniques.

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References
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Authors' information:

Yamshchikov Oleg Nikolaevich,
Doctor of Medical Sciences, Head of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Derzhavin Tambov State University; Chief Physician, Kotovsk City Clinical Hospital
ORCID ID: 0000-0001-6825-7599
SPIN: 9115-2547
E-mail: yamschikov.oleg@yandex.ru

Marchenko Aleksandr Petrovich,
Candidate of Medical Sciences, Associate Professor of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Derzhavin Tambov State University; Head of Anesthesiology and Intensive Care Department, Kotovsk City Clinical Hospital
ORCID ID: 0000-0002-9387-3374
SPIN: 9253-4117
E-mail: sashamarchen@mail.ru

Emelyanov Sergey Aleksandrovich,
Candidate of Medical Sciences, Associate Professor of the Department of Hospital Surgery with a Course of Traumatology, Medical Institute, Derzhavin Tambov State University; Deputy Chief Physician for Medical Affairs, Kotovsk City Clinical Hospital
ORCID ID :0000-0002-5550-4199
SPIN: 4368-8660
E-mail: cep_a@mail.ru

Ivanova Olga Dmitrievna,
Anesthesiologist-Resuscitator, I.S. Dolgushin Clinical Hospital № 3
ORCID ID: 0000-0002-4895-8600
SPIN: 5800-8948
E-mail: olg.dmi@mail.ru

Marchenko Ruslan Aleksandrovich,
Anesthesiologist-Resuscitator, National Medical Research Center for High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky
ORCID ID: 0000-0003-4933-3298
SPIN: 4790-3415
E-mail: gibsonrus@mail.ru

Ignatova Svetlana Alekseevna,
Resident Anesthesiologist-Resuscitator of the Department of Hospital Surgery with the course of Traumatology, Medical Institute, Derzhavin Tambov State University
ORCID ID: 0000-0003-4223-5038
E-mail: ignatowa.svet2015@ya.ru;

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

vanova Olga Dmitrievna
Anesthesiologist-Resuscitator, I.S. Dolgushin Clinical Hospital № 3

392000, Russian Federation, Tambov, Karl Marx str., 234/365

Tel.: +7 (980) 7836053

E-mail: olg.dmi@mail.ru

Materials on the topic:

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