Efficacy of Infraclavicular Brachial Plexus Block Versus Supraclavicular Brachial Plexus Block By Using Ultrasound Guided Nerve Stimulation Technique for Elective Upper Limb Surgeries a Randomised Controlled Trial

Abstract

Background
The supraclavicular and infraclavicular brachial plexus blocks have a similar distribution of anaesthesia, and both can be used effectively for surgeries of the upper limb. The present study aimed to compare the efficacy of Infraclavicular brachial plexus block and
supraclavicular brachial plexus block by using ultrasound guided nerve stimulation technique in elective upper limb surgeries.
Method A total 40 patients of both sexes and ASA 1 and 2 grades, were undergoing elective upper limb surgeries were enrolled and divided into two groups of 20 patients each. Group IPatients had infraclavicular block with Inj. ropivacaine 0.5% 15 ml and Inj 2% lignocaine with adrenaline 15 ml using an ultrasonographyguided peripheral nerve stimulator. Group SPatients had a supraclavicular block with Inj ropivacaine 0.5 % 15 ml and Inj 2 % lignocaine with adrenaline 15 ml using an ultrasonography-guided peripheral nerve stimulator.
Results
Group S took less time to complete a block (9.45±2.982 minutes) than group I (11.15±2.09 minutes), (p=0.07). Onset of sensory and motor block was early in group I as compared to group S with statistically significant difference, (p<0.001). Time to achieve sensory and
motor block was significantly longer in group I than group S, (p=0.001). Supraclavicular block required fewer needle pricks (1.45±0.945min), but infraclavicular block required (1.85±0.587min) needle pricks, (p=0.01). Group I had a higher success rate of block (85%) than S group (80%), which was not significant.
Conclusion

Both the techniques were safe to perform without any complications. Ultimately the technique to be used depends upon the availability of the instruments, choice of the anaesthetist, understanding and co-operation of the patient.