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INTRAVENOUS ANALGESIA with CHLOROPROCAINE
TRANSARTERIAL BRACHIAL PLEXUS BLOCK

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Philippe Durant, MD, PhD, Anaesthetist, Lausanne, Switzerland .

• Medical School : Catholic University of Louvain (Belgium).
  
• Anesthesia : Duke University (USA) and Mayo Clinic (USA). Diplomate of the American Board of Anesthesiologists.
• Pharmacology : PhD (Mayo Clinic, USA) and Postdoc (King’s College, London,UK)
• Formerly : Staff Anesthesiologist, Mayo Clinic.
• At present : Anaesthetist, Private practice, Lausanne, Switzerland.

This website is dedicated to two of my mentors, both of them of great integrity and totally devoted to regional analgesia :

• Albert Van Steenberge, a Belgian anaesthetist, ESRA founder, and fore-runner in the development of regional analgesia.
• Philip R. Bromage, a British anaesthetist, Professor at Duke University, and author of the great classic : « Epidural Analgesia »

This website describes two techniques, used every day in our Center, specialized in surgery of the upper and lower limbs. Both techniques are performed without ultrasound, and unfortunately considered by some as obsolete :

1. The Intravenous Regional Anaesthesia (IVRA) with chloroprocaine, 3,000 cases a year for more than 20 years (an experience of more than 60.000 cases !).
2. The Transarterial Brachial Plexus Block (TAB), 1,000 cases a year for more than 20 years (an experience of more than 20,000 cases !).
   

Those two techniques are perfectly adequate and safe to obtain excellent analgesia of the upper limb.

This website is intended to :

1. All anaesthetists because it is easy, safe and cheap.
   
2. Young physicians in training. Easy techniques should be taught first !
3. Experienced anaesthetists, those who do not practice regional analgesia on a regular basis.
4. Physicians in third-world countries, or anywhere there is a lack of technology or well trained anaesthetists.
5. Experts in ultrasound, when an extra-pair of hands is lacking or when their equipment has broken down.

This website questions « the whole ultrasound » way of thinking. To perform regional analgesia of the upper limb in particular, the use of ultrasound is an interesting adjunct. However, simple and effective techniques should be taught first to young physicians. And the more techniques we master, the better we are ! Last but not least, if those two techniques, IVRA and TAB, had to disappear from our armamentarium, because of the combined pressure of the legislator and « the ultrasound lobby », it would be very detrimental to our patients and to the specialty of anaesthesia in general.