Table 1.
Summary of local anesthetics used for peripheral nerve block*.
| Anesthetic | Volume (mL) | Drug (%) | Dose (mg/mL) | Type of block | Duration of analgesia (hours) | Comments | Reference |
|---|---|---|---|---|---|---|---|
| Ropivacaine | 30 | 0.75% | 7.5 | subclavian perivascular brachial plexus block | 11– 14 | Onset and duration of sensory and motor block was similar to 0.5% (30mLs) Bupivacaine. Median time to first analgesic request was 11 hours. Quality of analgesia was “excellent” for 67% (33/49) and “unsatisfactory” for 28% (14/49) of patients. | [Vaghadia, 1999 #1770] |
| 32 | 0.50% | 5.5 | Subclavian perivascular brachial plexus block (C5). Additional drug (3mLs) was used to separately block the intercostobrachial and medial brachial (T2) subcutaneous nerves. | 13– 14 | Frequency of analgesia (92%; 22/24) assessed across brachial plexus dermatomes (C5-T1) and was not different from 0.5% bupivacaine. Side effects included hand paralysis (83%; 19/24). Study did not monitor cardiovascular toxicity. | [Hickey, 1991 #1771] | |
| 25 | 0.75% | 7.5 | Femoral nerve block (10mL) followed by sciatic block (15mL) | 7– 15 | Study limited by small patient cohorts (n = 15) | [Fanelli, 1998 #1772] | |
| 32 | 0.75% | 7.5 | axillary brachial plexus block with additional drug (4mL) used to block the intercostobrachial cutaneous nerve | 8– 11 | 6.7% (2/30) of patients required intraoperative opioids following block. 100% (30/30) were satisfied with block. Significantly reduced mean onset time compared to 0.5% bupivacaine. | [Bertini, 1999 #1773] | |
| 32 | 0.50% | 5 | axillary brachial plexus block with additional drug (4mL) used to block the intercostobrachial cutaneous nerve | 7– 14 | 10% (3/30) of patients required intraoperative opioids following block. 93.4% (28/30) were satisfied with block. | [Bertini, 1999 #1773] | |
| 45 | 0.50% | 5 | perivascular axillary brachial plexus block | 11– 24 | Two telephone interviews were used to assess duration of block, at 8– 11hrs and 20– 26hrs following injection. 3.3 % (1/30) patients had inadequate block and required followup general anesthesia. Average time to first postoperative analgesic was 15hrs. | [Liisanantti, 2004 #1774] | |
| Bupivacaine | 32 | 0.50% | 5 | subclavian perivascular brachial plexus block | 10– 17 | Median time to first analgesic request occurred was 12 hours. Quality of analgesia was “excellent” for 53% (26/49) and “unsatisfactory” for 34% (17/49) of patients. | [Vaghadia, 1999 #1770] |
| 25 | 0.50% | 5 | Femoral nerve block (10mL) followed by sciatic block (15mL) | 9– 20 | Study limited by small patient cohorts (n = 15). Adequate surgical anesthesia took up to 50 minutes. | [Fanelli, 1998 #1772] | |
| 32 | 0.50% | 5 | subclavian perivascular brachial plexus block, intercostobrachial and medial brachial subcutaneous block | 13– 14 | 91% (21/24) of patients reported hand paralysis. Patients had a increased incidence of Horner’s Syndrome compared to 0.5% ropivacaine. Study did not monitor cardiovascular toxicity. | [Hickey, 1991 #1771] | |
| 32 | 0.50% | 5 | axillary brachial plexus block with additional drug (4mL) used to block the intercostobrachial cutaneous nerve | 7– 14 | 23.3% (7/30) of patients required intraoperative opioids following block. 73.3% (22/30) were satisfied with block. | [Bertini, 1999 #1773] | |
| 20 | 0.50% | 5 | Three-in-one block: perivascular inguinal injection to block the femoral, lateral cutaneous and obturator nerves | 13– 21 | Onset to analgesia (27min) was similar to patients that received 0.5% or 0.25% dose of levobupivacaine | [Urbanek, 2003 #1775] | |
| 45 | 0.50% | 5 | perivascular axillary brachial plexus block | 11– 27 | Two telephone interviews were used to assess duration of block, at 8– 11hrs and 2026hrs following injection. Average time to first postoperative analgesic was 18hrs. | [Liisanantti, 2004 #1774] | |
| Levobupivacaine | 45 | 0.50% | 5 | perivascular axillary brachial plexus block | 11– 27 | Two telephone interviews were used to assess duration of block, at 8– 11hrs and 2026hrs following injection. 6.7 % (2/30) patients had inadequate block and required followup general anesthesia. Average time to first postoperative analgesic was 17hrs. | [Liisanantti, 2004 #1774] |
| 20 | 0.50% | 5 | Three-in-one block: perivascular inguinal injection to block the femoral, lateral cutaneous and obturator nerves | 14– 19 | Comparable to 0.5% bupivacaine with respect to duration of analgesia for three-in-one block. | [Urbanek, 2003 #1775] | |
| 20 | 0.25% | 2.5 | Three-in-one block: perivascular inguinal injection to block the femoral, lateral cutaneous and obturator nerves | 9– 14 | 45% of patients (9/20) reported complete sensory block after initial 60 min. following injection. Further studies needed to confirm efficacy of anesthetic effect at this dose. | [Urbanek, 2003 #1775] | |
| Lidocaine | 10 | 1% | __ | parasacral sciatic, proximal interfacial obturator, and lateral femoral cutaneous nerve block | __ | 89% of patients reported successful block with a dose of 0.93% w/v (15mL) | [Taha, 2013 #1776] |
| Dextrose prolotherapy | 30 | 2% Lidocaine hydrochloride (20mL) with epinephrine 1:200,000 with 5% dextrose (10mL) | __ | brachial plexus block | __ | Ultrasound guided injection of 2% lidocaine alone or combined with 5% dextrose produced similar sensory and motor block | [Mosaffa, 2020 #1878] |
| -- | 0.5% ropivacaine with 5% dextrose | -- | axillary brachial plexus block | 12– 13 | The addition of dextrose decreased the time of onset of regional block (15 min) compared to 0.5% ropivacaine alone (22 min). | [Dhir, 2008 #1879] |
*
Information not provided in the publication is left blank with a dash in the box.