Preliminary Evaluation of Infraclavicular Catheters Inserted Using Ultrasound Guidance: Through-the-Catheter Anesthesia Is Not Inferior to Through-the-Needle Blocks
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: This prospective study compared the initial block quality and surgical anesthesia rates of ultrasound-guided infraclavicular blocks with local-anesthetic injected through a catheter versus through a needle. We hypothesized that positioning of the catheter immediately posterior to the axillary artery would produce through-the-catheter (TTC) anesthesia with rates of complete block not inferior to through-the-needle (TTN) injection. METHODS: Eighty patients undergoing hand or forearm surgery extensive enough to require regional anesthesia were randomized into 2 groups of 40. In group TTN, local anesthetic was deposited posterior, lateral, and medial to the axillary artery using as few injections as necessary. In group TTC, a 20-gauge, multiorifice catheter was positioned between the posterior wall of the axillary artery and the posterior cord of the brachial plexus. All blocks were performed by use of ultrasound visualization with a 6-MHz to 10-MHz 38-mm linear probe. Local-anesthetic solution consisted of 0.5 mL/kg lidocaine 2% with epinephrine. Sensory and motor blocks, as well as supplementation rates, were evaluated for the musculocutaneous, median, radial, and ulnar nerves. RESULTS: Complete sensory block of all nerve territories was achieved in 92% of patients in group TTN and 90% in group TTC (P = .51). In group TTN, 90% of patients had satisfactory anesthesia for surgery (no discomfort and no need for anesthetic supplementation of any type) compared with 92% in group TTC (P = .51). CONCLUSION: Ultrasound-guided TTC infraclavicular block produced perioperative anesthesia that was not inferior to a TTN technique.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".