The effects of axillary block using the multiple injection method with ropivacaine in uremic and nonuremic patients*

Aim: To compare the sensory and motor block quality in axillary brachial plexus block using the multiple injection method with ropivacaine in uremic and nonuremic patients. Materials and methods: Examined were 60 patients scheduled for orthopedic surgery of the distal upper extremity (nonuremic group: group N, n = 30) or creation of an arteriovenous fistula (uremic group: group U, n = 30) with an axillary brachial plexus block. The median, radial, ulnar, and musculocutaneous nerves were selectively localized by nerve stimulation. After obtaining an appropriate peripheral motor response, predetermined volumes of ropivacaine (0.5%), in accordance with a formula, were selectively injected to the 4 nerves by multiple injections in both groups. Sensory and motor block were assessed. Results: At 30 min, complete sensory and motor block was observed at a rate of 95% in the ulnar nerve innervation area and 100% in the other 3 nerves in group U, whereas these rates were 95% in the musculocutaneous nerve innervation area and 100% in the other 3 nerves in group N. There was no statistically signifi cant difference between the groups. Conclusion: Axillary brachial plexus block using the multiple injection method with ropivacaine in uremic and nonuremic patients provided a similarly good quality of the block and lack of systemic toxicity.