Table of Contents Author Guidelines Submit a Manuscript
Anesthesiology Research and Practice
Volume 2010, Article ID 309462, 7 pages
Research Article

Different Learning Curves for Axillary Brachial Plexus Block: Ultrasound Guidance versus Nerve Stimulation

1Department of Anesthesiology and Pain Therapy, University Hospital and University of Bern, Inselspital, CH-3010 Bern, Switzerland
2Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Kantonsspital Lucerne, 6000 Lucerne, Switzerland

Received 5 November 2010; Accepted 29 December 2010

Academic Editor: Jacques E. Chelly

Copyright © 2010 C. Luyet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Little is known about the learning of the skills needed to perform ultrasound- or nerve stimulator-guided peripheral nerve blocks. The aim of this study was to compare the learning curves of residents trained in ultrasound guidance versus residents trained in nerve stimulation for axillary brachial plexus block. Ten residents with no previous experience with using ultrasound received ultrasound training and another ten residents with no previous experience with using nerve stimulation received nerve stimulation training. The novices' learning curves were generated by retrospective data analysis out of our electronic anaesthesia database. Individual success rates were pooled, and the institutional learning curve was calculated using a bootstrapping technique in combination with a Monte Carlo simulation procedure. The skills required to perform successful ultrasound-guided axillary brachial plexus block can be learnt faster and lead to a higher final success rate compared to nerve stimulator-guided axillary brachial plexus block.