Distribución circunferencial vs no circunferencial de mepivacaína en nervio mediano y cubital para cirugía del síndrome del túnel del carpoensayo clínico aleatorizado, doble ciego

Abstract

The present doctoral thesis corresponds to a randomized double-blind clinical trial that evaluated the efficacy and rapidity of action of mepivacaine by comparing its circumferential distribution (C) vs. non-circumferential (NC) around the median nerve (N) and ulnar N. A peripheral nerve block guided by ultrasound was performed in the antecubital fossa of 124 patients scheduled for surgery of the carpal tunnel syndrome. The incidence of inadvertent intraneural injection was calculated by separating these cases from the rest of the results. At 5 min group C obtained anesthesia 2.40 (1.01-5.77) times more in the median N and 3.05 (1.28-7.24) in the ulnar N compared to the NC group. The efficacy in the median N reached 100% in both groups and in the ulnar N 100% in C vs. 97.8% in NC. The complete motor block in group C occurred more frequently than in the NC: in the median N 1.59 (1.12-2.26) times more at 15 min and 1.12 (1.01-1.25) at 30 min, while in the ulnar N, 1.78 (1.22-2.60) at 15 min and 1.23 (1.07-1.41) at 30 min. The C distribution of AL provides greater rapidity and complete motor block than the NC with similar efficacy.