Practical Problems of Continuous Axillary Block Using Tuohy needle and Epidural Catheter

Abstract

The practical problems of continuous axillary block using not intravenous catheter but Tuohy needle and fine polyethylene catheter (1mm O.D.) which are usually used for continuous epidural block are analyzed. In 32 cases (29 for surgical operation and 3 for posttraumatic pain management) continuous axillary block was performed with the result of 78.1% full success and 12.5% partial success.
The advantages of this new technique are as follows: (1) easy preparation (2) easy detection of neurovascular sheath (3) safety for nerves and vessels (4) no disconnection or kinking of catheter (5) easy fixation. However there still exists a problem of reliability which is fundamental and common one to catheter technique either intravenous or epidural catheter of brachial plexus block. Because the complete block of brachial plexus in single needle (catheter) technique depends on the free spread of local anesthetic solution in the neurovascular sheath, so that individual anatomical or pathological peculiarity which prevents free spread of the solution may result in partial incomplete block.