Brachial plexus blocks: a review of approaches and techniques

  • Quang Hieu De Tran
  • Antonio Clemente
  • Julian Doan
  • Roderick J. Finlayson
Review Articles/Brief Reviews


Brachial Plexus Radial Nerve Brachial Plexus Block Musculocutaneous Nerve Axillary Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Les blocs du plexus brachial: compte-rendu des approches et techniques


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  1. 1.
    Neal JM, Hebl JR, Gerancher JC, Hogan QH. Brachial plexus anesthesia: essentials of our current understanding. Reg Anesth Pain Med 2002; 27:402–28.PubMedGoogle Scholar
  2. 2.
    Perlas A, Chan VW, Simons M. Brachial plexus examination and localization using ultrasound and electrical stimulation: a volunteer study. Anesthesiology 2003; 99:429–35.CrossRefPubMedGoogle Scholar
  3. 3.
    Rucci FS, Pippa P, Barbagli R, Doni L. How many interscalenic blocks are there? A comparison between the lateral and posterior approach. Eur J Anaesthesiol 1993; 10:303–7.PubMedGoogle Scholar
  4. 4.
    Rettig HC, Gielen MJ, Jack NT, Boersma E, Klein J. A. A comparison of the lateral and posterior approach for brachial plexus block. Reg Anesth Pain Med 2006; 31:119–26.CrossRefPubMedGoogle Scholar
  5. 5.
    Dewees JL, Schultz CT, Wilkerson FK, Kelly JA, Biegner AR, Pellegrini JE. Comparison of two approaches to brachial plexus anesthesia for proximal upper extremity surgery: interscalene and intersternocleidomastoid. AANA J 2006; 74:201–6.PubMedGoogle Scholar
  6. 6.
    Arcand G, Williams SR, Chouinard P, et al. Ultrasound-guided infraclavicular versus supraclavicular block. Anesth Analg 2005; 101:886–90.CrossRefPubMedGoogle Scholar
  7. 7.
    Fleck JW, Moorthy SS, Daniel J, Dierdorf SF. Brachial plexus block. A comparison of the supraclavicular lateral paravascular and axillary approaches. Reg Anesth 1994; 19:14–7.PubMedGoogle Scholar
  8. 8.
    Kapral S, Kraft P, Eibenberger K, Fitzgerald R, Gosch M, Weinstabl C. Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994; 78:507–13.CrossRefPubMedGoogle Scholar
  9. 9.
    Kapral S, Jandrasits O, Schabernig C, et al. Lateral infraclavicular plexus block vs. axillary block for hand and forearm surgery. Acta Anaesthesiol Scand 1999; 43:1047–52.CrossRefPubMedGoogle Scholar
  10. 10.
    Fleischmann E, Marhofer P, Greher M, Waltl B, Sitzwohl C, Kapral S. Brachial plexus anesthesia in children: lateral infraclavivular vs axillary approach. Paediatr Anaesth 2003; 13:103–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Rettig HC, Gielen JM, Boerma E, Klein J. A comparison of the vertical infraclavivular and axillary approaches for brachial plexus anaesthesia. Acta Anaesthesiol Scand 2005; 49:1501–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Heid FM, Jage J, Guth M, Bauwe N, Brambrink AM. Efficacy of vertical infraclavicular plexus block vs. modified axillary plexus block: a prospective, randomized, observer-blinded study. Acta Anaesthesiol Scand 2005; 49:677–82.CrossRefPubMedGoogle Scholar
  13. 13.
    Deleuze A, Gentili ME, Marret E, Lamonerie L, Bonnet F. A comparison of a single-stimulation lateral infraclavicular plexus block with a triple-stimulation axillary block. Reg Anesth Pain Med 2003; 28:89–94.CrossRefPubMedGoogle Scholar
  14. 14.
    Koscielniak-Nielsen ZJ, Rasmussen H, Hesselbjerg L, Nielsen TP, Gurkan Y. Infraclavicular block causes less discomfort than axillary block in ambulatory patients. Acta Anaesthesiol Scand 2005; 49:1030–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Koscieniak-Nielsen ZJ, Rotboll Nielsen P, Risby Mortensen C. A comparison of coracoid and axillary approaches to the brachial plexus. Acta Anaesthesiol Scand 2000; 44:274–9.CrossRefGoogle Scholar
  16. 16.
    ErtugZ, Yegin A, Ertem S, et al. Comparison of two different techniques for brachial plexus block: infra-clavicular versus axillary technique. Acta Anaesthesiol Scand 2005; 49:1035–9.CrossRefGoogle Scholar
  17. 17.
    Minville V, Amathieu R, Luc N, et al. Infraclavicular brachial plexus block versus humeral approach: comparison of anesthetic time and efficacy. Anesth Analg 2005; 101:1198–201.CrossRefPubMedGoogle Scholar
  18. 18.
    Minville V, Fourcade O, Idabouk L, et al. Infraclavicular brachial plexus block versus humeral block in trauma patients: a comparison of patient comfort. Anesth Analg 2006; 102:912–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Bouaziz H, Narchi P, Mercier FJ, et al. Comparison between conventional axillary block and a new approach at the midhumeral level. Anesth Analg 1997; 84:1058–62.CrossRefPubMedGoogle Scholar
  20. 20.
    Fuzier R, Fourcade O, Pianezza A, Gilbert ML, Bounes V, Olivier M. A comparison between double-injection axillary brachial plexus block and midhumeral block for emergency upper limb surgery. Anesth Analg 2006; 102:1856–8.CrossRefPubMedGoogle Scholar
  21. 21.
    March X, Pardina B, Torres-Bahi S, Navarro M, del Mar Garcia M, Villalonga A. A comparison of a triple-injection axillary brachial plexus block with the humeral approach. Reg Anesth Pain Med 2003; 28:504–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Sia S, Lepri A, Campolo MC, Fiaschi R. Four-injection brachial plexus block using peripheral nerve stimulator: a comparison between axillary and humeral approaches. Anesth Analg 2002; 95:1075–9.PubMedGoogle Scholar
  23. 23.
    Koscielniak-Nielsen ZJ, Rasmussen H, Nielsen PT. Patients’ perception of pain during axillary and humeral blocks using multiple nerve stimulations. Reg Anesth Pain Med 2004; 29:328–32.CrossRefPubMedGoogle Scholar
  24. 24.
    Liguori GA, Zayas VM, YaDeau JT, et al. Nerve localization techniques for interscalene brachial plexus blockade: a prospective, randomized comparison of mechanical paresthesia versus electrical stimulation. Anesth Analg 2006; 103:761–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Smith BL. Efficacy of a nerve stimulator in regional anesthesia; experience in a resident training programme. Anaesthesia 1976; 31:778–82.CrossRefPubMedGoogle Scholar
  26. 26.
    Boezaart AP, de Beer JF, du Toit C, van Rooyen K. A new technique of continuous interscalene nerve block. Can J Anesth 1999; 46:275–81.CrossRefPubMedGoogle Scholar
  27. 27.
    Soeding PE, Sha S, Royse CE, Marks P, Hoy G, Royse AG. A randomized trial of ultrasound-guided brachial plexus anaesthesia in upper limb surgery. Anaesth Intensive Care 2005; 33:719–25.PubMedGoogle Scholar
  28. 28.
    Urmey WF, Talts KH, Sharrock NE. One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg 1991; 72:498–503.CrossRefPubMedGoogle Scholar
  29. 29.
    Urmey WF, McDonald M. Hemidiaphragmatic paresis during interscalene brachial plexus block: effects on pulmonary function and chest wall mechanics. Anesth Analg 1992; 74:352–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Urmey WF, Gloeggler PJ. Pulmonary function changes during interscalene brachial plexus block: effects of decreasing local anesthetic injection volume. Reg Anesth 1993; 18:244–9.PubMedGoogle Scholar
  31. 31.
    Urmey WF, Grossi P, Sharrock N, Stanton J, Gloeggler PJ. Digital pressure during interscalene block is clinically ineffective in preventing anesthetic spread to the cervical plexus. Anesth Analg 1996; 83:366–70.CrossRefPubMedGoogle Scholar
  32. 32.
    Bennani SE, Vandenabele-Teneur F, Nyarwaya JB, Delecroix M, Krivosic-Horber R. An attempt to prevent spread of local anaesthetic to the phrenic nerve by compression above the injection site during the interscalene brachial plexus block. Eur J Anaesthesiol 1998; 15:453–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Sala-Blanch X, LazaroJR, CorreaJ, Gomez-Fernandez M. Phrenic nerve block caused by interscalene brachial plexus block: effects of digital pressure and a low volume of local anesthetic. Reg Anesth Pain Med 1999; 24:231–5.CrossRefPubMedGoogle Scholar
  34. 34.
    al-Kaisy AA, Chan VW, Perlas A. Respiratory effects of low-dose bupivacaine interscalene block. Br J Anaesth 1999; 82:217–20.CrossRefPubMedGoogle Scholar
  35. 35.
    Martinez J, Sala-Blanch X, Ramos I, Gomar C. Combined infraclavicular plexus block with supra-scapular nerve block for humeral head surgery in a patient with respiratory failure: an alternative approach. Anesthesiology 2003; 98:784–5.CrossRefPubMedGoogle Scholar
  36. 36.
    Ritchie ED, Tong D, Chung F, Norris A, Miniaci A, Vairavanathan SD. Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality? Anesth Analg 1997; 84:1306–12.CrossRefPubMedGoogle Scholar
  37. 37.
    Singelyn FJ, Lhotel L, Fabre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraar-ticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg 2004; 99:589–92.CrossRefPubMedGoogle Scholar
  38. 38.
    Neal JM, McDonald SB, Larkin KL, Polissar NL. Suprascapular nerve block prolongs analgesia after non-arthroscopic shoulder surgery but does not improve outcome. Anesth Analg 2003; 96:982–6.CrossRefPubMedGoogle Scholar
  39. 39.
    Dalens B, Vanneuville G, Tanguy A. A new parascalene approach to the brachial plexus in children: comparison with the supraclavicular approach. Anesth Analg 1987; 66:1264–71.PubMedGoogle Scholar
  40. 40.
    Kulenkampff D, Persy MA. Brachial plexus anesthesia: its indications, technique and dangers. Ann Surg 1928; 87:883–91.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Franco CD, Domashevich V, Voronov G, Rafizad AB, Jelev TJ. The supraclavicular block with a nerve stimulator: to decrease or not to decrease, that is the question. Anesth Analg 2004; 98:1167–71.CrossRefPubMedGoogle Scholar
  42. 42.
    Hickey R, Hoffman J, Ramamurthy S. Transarterial techniques are not effective for subclavian perivascular block. Reg Anesth 1990; 15:245–9.PubMedGoogle Scholar
  43. 43.
    Williams SR, Chouinard P, Arcand G, et al. Ultrasound guidance speeds the execution and improves the quality of supraclavicular block. Anesth Analg 2003; 97:1518–23.CrossRefPubMedGoogle Scholar
  44. 44.
    Bigeleisen P, Wilson M. A comparison of two techniques for ultrasound guided infraclavicular block. Br J Anaesth 2006; 96:502–7.CrossRefPubMedGoogle Scholar
  45. 45.
    RodriguezJ, Taboada-Muniz M, Barcena M, Alvarez J. Median versus musculocutaneous nerve response with single-injection infraclavicular coracoid block. Reg Anesth Pain Med 2004; 29:534–8.CrossRefGoogle Scholar
  46. 46.
    Lecamwasam H, Mayfield J, Rosow L, Chang Y, Carter C, Rosow C. Stimulation of the posterior cord predicts successful infraclavicular block. Anesth Analg 2006; 102:1564–8.CrossRefPubMedGoogle Scholar
  47. 47.
    Bloc S, Garnier T, Komly B, et al. Single-stimulation, low-volume infraclavicular plexus block: influence of the evoked distal motor response on success rate. Reg Anesth Pain Med 2006; 31:433–7.PubMedGoogle Scholar
  48. 48.
    Gaertner E, Estebe JP, Zamfir A, Cuby C, Macaire P. Infraclavicular plexus block: multiple injection versus single injection. Reg Anesth Pain Med 2002; 27:590–4.PubMedGoogle Scholar
  49. 49.
    Rodriguez J, Barcena M, LagunillaJ, Alvarez J. Increased success rate with infraclavicular brachial plexus block using a dual-injection technique. J Clin Anesth 2004; 16:251–6.CrossRefPubMedGoogle Scholar
  50. 50.
    Rodriguez J, Barcena M, Taboada-Muniz M, Lagunilla J, Alvarez J. A comparison of single versus multiple injections on the extent of anesthesia with coracoid infraclavicular brachial plexus block. Anesth Analg 2004; 99:1225–30.CrossRefPubMedGoogle Scholar
  51. 51.
    Fuzier R, Fourcade O, Fuzier V, Albert N, Samii K, Olivier M. Double- vs. single-injection infraclavicular plexus block in the emergency setting: higher success rate with lower volume of local anaesthetic. Eur J Anaesthesiol 2006; 23:271–5.CrossRefPubMedGoogle Scholar
  52. 52.
    Minville V, Asehoune K, Chassery C, et al. Resident versus staff anesthesiologist performance: coracoid approach to infraclavicular brachial plexus blocks using a double-stimulation technique. Reg Anesth Pain Med 2005; 30:233–7.PubMedGoogle Scholar
  53. 53.
    Marhofer P, Sitzwohl C, Greher M, Kapral S. Ultrasound guidance for infraclavicular brachial plexus anaesthesia in children. Anaesthesia 2004; 59:642–6.CrossRefPubMedGoogle Scholar
  54. 54.
    Hill DA, Campbell WI. Two approaches to the axillary brachial plexus. Loss of resistance to saline or paraes-thesia? Anaesthesia 1992; 47:207–9.PubMedGoogle Scholar
  55. 55.
    Baranowski AP, Pither CE. A comparison of three methods of axillary brachial plexus anaesthesia. Anaesthesia 1990; 45:362–5.CrossRefPubMedGoogle Scholar
  56. 56.
    Tuominen MK, Pitkanen MT, Numminen MK, Rosenberg PH. Quality of axillary brachial plexus block. Comparison of success rate using perivascular and nerve stimulator techniques. Anaesthesia 1987; 42:20–2.CrossRefPubMedGoogle Scholar
  57. 57.
    Rodriguez J, Carceller J, Barcena M, Pedraza I, Calvo B, Alvarez J. Cold saline is more effective than room temperature saline in inducing paresthesia during axillary block. Anesth Analg 1995; 81:329–31.PubMedGoogle Scholar
  58. 58.
    Rodriguez J, Barcena M, Alvarez J. Axillary brachial plexus anesthesia: electrical versus cold saline stimulation. Anesth Analg 1996; 83:752–4.CrossRefPubMedGoogle Scholar
  59. 59.
    Youssef MS, Desgrand DA. Comparison of two methods of axillary brachial plexus anaesthesia. Br J Anaesth 1988; 60:841–4.CrossRefPubMedGoogle Scholar
  60. 60.
    Koscielniak-Nielsen ZJ, Hesselbjerg L, Fejlberg V. Comparison of transarterial and multiple nerve stimulation techniques for an initial axillary block by 45 mL of mepivacaine 1% with adrenaline. Acta Anaesthesiol Scand 1998; 42:570–5.CrossRefPubMedGoogle Scholar
  61. 61.
    Turkan H, Baykal B, Ozisik T. Axillary brachial plexus blockade: an evaluation of three techniques. Mil Med 2002; 167:723–5.PubMedGoogle Scholar
  62. 62.
    Pere P, Pitkanen M, Tuominen M, Edgren J, Rosenberg PH. Clinical and radiological comparison of perivascular and transarterial techniques of axillary brachial plexus block. Br J Anaesth 1993; 70:276–9.CrossRefPubMedGoogle Scholar
  63. 63.
    Koscielniak-Nielsen ZJ, Nielsen PR, Nielsen SL, Gardi T, Hermann C. Comparison of transarterial and multiple nerve stimulation techniques for axillary block using a high dose of mepivacaine with adrenaline. Acta Anaesthesiol Scand 1999; 43:398–404.CrossRefPubMedGoogle Scholar
  64. 64.
    Hickey R, Hoffman J, Tingle LJ, Rogers JN, Ramamurthy SJ. Comparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block. Reg Anesth 1993; 18:335–8.PubMedGoogle Scholar
  65. 65.
    Jones TS. Comparison of axillary block techniques: is there a difference in success rates? AANA J 1997; 65:257–9.PubMedGoogle Scholar
  66. 66.
    Koscielniak-Nielsen ZJ, Rotboll Nielsen P, Sorensen T, Stenor M. Low dose axillary block by targeted injections of the terminal nerves. Can J Anesth 1999; 46:658–64.CrossRefPubMedGoogle Scholar
  67. 67.
    Goldberg ME, Gregg C, Larijani GE, Norris MC, Marr AT, Seltzer JL. A comparison of three methods of axillary approach to brachial plexus blockade for upper extremity surgery. Anesthesiology 1987; 66:814–6.CrossRefPubMedGoogle Scholar
  68. 68.
    Rucci FS, Pippa P, Boccaccini A, Barbagli R. Effect of injection speed on anaesthetic spread during axillary block using the orthogonal two-needle technique. Eur J Anaesthesiol 1995; 12:505–11.PubMedGoogle Scholar
  69. 69.
    Sia S, Bartoli M, Lepri A, Marchini O, Ponsecchi P. Multiple-injection axillary brachial plexus block: a comparison of two methods of nerve localization-nerve stimulation versus paresthesia. Anesth Analg 2000; 91:647–51.CrossRefPubMedGoogle Scholar
  70. 70.
    Rucci FS, Boccaccini A, Doni L, Pippa P. The orthogonal two-needle technique: a new axillary approach to the brachial plexus. Eur J Anaesthesiol 1995; 12:333–9.PubMedGoogle Scholar
  71. 71.
    Rodriguez J, Taboada M, Del Rio S, Barcena M, Alvarez J. A comparison of four stimulation patterns in axillary block. Reg Anesth Pain Med 2005; 30:324–8.CrossRefPubMedGoogle Scholar
  72. 72.
    Koschielniak-Nielsen ZJ, Christensen LQ, Pedersen HL, Brusho J. Effect of digital pressure on the neurovascular sheath during perivascular axillary block. Br J Anaesth 1995; 75:702–6.CrossRefPubMedGoogle Scholar
  73. 73.
    LavoieJ, Martin R, TetraultJP, Cote DJ, Colas MJ. Axillary plexus block using a peripheral nerve stimulator: single or multiple injections. Can J Anaesth 1992; 39:583–6.CrossRefGoogle Scholar
  74. 74.
    Koscielniak-Nielsen ZJ, Stens-Pedersen HL, Lippert FK. Readiness for surgery after axillary block: single or multiple injection techniques. Eur J Anaesthesiol 1997; 14:164–71.CrossRefPubMedGoogle Scholar
  75. 75.
    Inberg P, Annila I, Annila P. Double-injection method using peripheral nerve stimulator is superior to single injection in axillary plexus block. Reg Anesth Pain Med 1999; 24:509–13.CrossRefPubMedGoogle Scholar
  76. 76.
    Carre P, Joly A, Cluzel Field B, Wodey E, Lucas MM, Ecoffey C. Axillary block in children: single or multiple injection? Paediatr Anaesth 2000; 10:35–9.CrossRefPubMedGoogle Scholar
  77. 77.
    Rodriguez J, Taboada M, Valino C, Barcena M, Alvarez J. A comparison of stimulation patterns in axillary block: part 2. Reg Anesth Pain Med 2006; 31:202–5.PubMedGoogle Scholar
  78. 78.
    Sia S, Lepri A, Ponzecchi P. Axillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection techniques. Reg Anesth Pain Med 2001; 26:499–503.PubMedGoogle Scholar
  79. 79.
    Coventry DM, Barker KF, Thomson M. Comparison of two neurostimulation techniques for axillary brachial plexus blockade. Br J Anaesth 2001; 86:80–3.CrossRefPubMedGoogle Scholar
  80. 80.
    Sia S, Bartoli M. Selective ulnar nerve localization is not essential for axillary brachial plexus block using a multiple nerve stimulation technique. Reg Anesth Pain Med 2001; 26:12–6.CrossRefPubMedGoogle Scholar
  81. 81.
    Sia S. A comparison of injection at the ulnar and the radial nerve in axillary block using triple stimulation. Reg Anesth Pain Med 2006; 31:514–8.CrossRefPubMedGoogle Scholar
  82. 82.
    Sia S, Lepri A, Magherini M, Doni L, Di Marco P, Gritti G. A comparison of proximal and distal radial nerve motor responses in axillary block using triple stimulation. Reg Anesth Pain Med 2005; 30:458–63.CrossRefPubMedGoogle Scholar
  83. 83.
    Sites BD, Beach ML, Spence BC, et al. Ultrasound guidance improves the success rate of a perivascular axillary plexus block. Acta Anaesthesiol Scand 2006; 50:678–84.CrossRefPubMedGoogle Scholar
  84. 84.
    Guntz E, Herman P, Delbos A, Sonowski M. The radial nerve should be blocked before the ulnar nerve during a brachial plexus block at the humeral canal. Can J Anesth 2004; 51:354–7.CrossRefPubMedGoogle Scholar
  85. 85.
    Ortells-Polo MA, Garcia-Guiral M, Garcia-Amigueti FJ, Carral-Olondris JN, Garcia-Godino T, Aguiar-Mojarro JA. Brachial plexus anesthesia: results of a modified perivascular supraclavicular technique (Spanish). Rev Esp Anestesiol Reanim 1996; 43:94–8.PubMedGoogle Scholar
  86. 86.
    Nitta K, Yamamoto K, Itoh H, Ohmura S, Kobayashi T Comparison of transarterial technique and paresthesia technique of axillary brachial plexus block (Japanese). Masui 1998; 47:156–60.PubMedGoogle Scholar
  87. 87.
    Neuburger M, Kaiser H, Rembold-Schuster I, Landes H. Vertical infraclavicular brachial-plexus blockade. A clini cal study of reliability of a new method for plexus anesthesia of the upper extremity (German). Anaesthesist 1998; 47:595–9.CrossRefPubMedGoogle Scholar
  88. 88.
    DesbordesJ, Mille FX, Adnet P, Boittiaux P, Forget AP. Brachial plexus anesthesia via an axillary route for emergency surgery: comparison of three approach methods (French). Ann Fr Anesth Reanim 1998; 17:674–80.CrossRefGoogle Scholar
  89. 89.
    Caputo F, Ventura R. Brachial plexus block. Effect of low interscalenic approach on phrenic nerve paresis (Italian). Minerva Anestesiol 2000; 66:195–9.PubMedGoogle Scholar
  90. 90.
    Liu FC, LiouJT, Tsai YF, Li AH, Day YY, Hui YL, Lui PW. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method (Chinese). Chang Gung Med J 2005; 28:396–402.PubMedGoogle Scholar
  91. 91.
    Sarradell Catalan AS, Moncho Rodriguez JM, Santos Carnes JA, Herrero Car bo R, Villanueva Ferrer JA, Masdeu Castellvi J. Axillary brachial plexus anesthesia, how many nerve stimulation responses do we look for? (Spanish). Rev Esp Anestesiol Reanim 2001; 48:356–63.Google Scholar
  92. 92.
    Che XH, Liang WM, Chen JY. Triple-injection axillary brachial plexus block: a comparison of two nerve-localization techniques, nerve stimulation versus paresthesia (Chinese). Acta Acad Med Shanghai 2005; 32:529–35.Google Scholar
  93. 93.
    Handoll HH, Koscielniak-Nielsen ZJ. Single, double or multiple injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery. Cochrane Database Syst Rev 2006; 1:CD003842.PubMedGoogle Scholar

Copyright information

© Canadian Anesthesiologists 2007

Authors and Affiliations

  • Quang Hieu De Tran
    • 1
  • Antonio Clemente
    • 1
  • Julian Doan
    • 1
  • Roderick J. Finlayson
    • 1
  1. 1.Department of Anesthesia, Montreal General HospitalMcGill UniversityMontrealCanada

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