Background and Goal of Study: compare ultrasound to the association ultrasound neurostimulation in terms of minimum effective dose of bupivacaïne in the supra clavicular block (SCB)

Materials and Methods:68 patients included in a prospective study and proposed humerus fracture are randomized in 2groups :GU (SCB under ultrasound using the technique in the plane with injection at posterior beam brachial plexus) and GUN (SCB the Echoplex needle connected to the neurostimulator is inserted under ultrasound guidance). Bupivacaine Injection is when you have a contraction of the deltoid to an intensity of 0.5 mA. In the 2 groups, the injection of the initial volume of 35 ml of 0.25% bupivacaine .if success SCB decreases the dose of 3 mL. if not, it is increased by 3 ml. was determined by using up-and-down method of Dixon and Massey, the DM50 and DM90%% minimum doses for 50% and 90% success of SCB in the 2 groups.

Results and Discussion:

	GU	GUN	p
Age (years)	47,8±16,9	51,2±11,2	0,21
BMI(kg/m²)	23,6±1,9	22,8±2,4	0,17
Sex-ratio	2,33	1,22	0,11
SCB procedure	4,1±1,8	6,3±2,4	0,044
duration (min)			
			
SCB success	31/34	28/34	0,31
rate			
			
DM50%(ml)	18,9±3,8	23,7±2,8	0,04
DM90%(ml)	22,7±4,1	27,6±3,9	0,027
 


Conclusion(s): The combination of the neurostimulator ultrasound does not reduce the doses of local anesthetics on the contrary it requires higher doses


01 / Ultrasound verus ultrasound associated to neurostimulation: Bupivacaine minimum dose in the supraclavicular block