Abstract

The purpose of the study was to assess the variation in depth of the brachial plexus using ultrasound among patients undergoing upper limb surgery under an ultrasound-guided supraclavicular brachial plexus block. The secondary objective of this study was to find out the correlation between the depth of insertion of the needle in the supraclavicular brachial plexus block and factors like age, sex, height, weight, and BMI. Methodology: In this cross-sectional study, the supraclavicular fossa of 100 patients with ASA status I and II, aged 20–60 years, of either gender and posted for upper limb surgeries under supraclavicular block at a tertiary care centre were scanned using a high-frequency linear probe of an ultrasound machine. An optimal image, including the subclavian artery and nerve bundles, was obtained. The shortest distance (SD) from skin to the most superficial neural element and the longest distance (LD) from skin to the deepest neural element were measured. Pearson’s correlation was used to calculate the strength and significance of the relation between SD and LD from the skin to the brachial plexus and variables like age, weight, height, and BMI. For variation in SD and LD with gender, the t test was used. Analysis was done using SPSS 20.0. Results: In this study, the mean shortest distance was 0.6± 0.2 cm and the mean longest distance was 1.5 ± 0.3 cm. The mean SD in males was 0.54 ± 0.16 cm, which was significantly lower than 0.76 ± 0.19 cm in females (p< 0.01).The mean LD in males was 1.34 ± 0.28 cm, which was significantly lower than 1.64 ± 0.32 cm in females (p<0.01). There was a significant positive correlation between SD and weight as well as BMI (p<0.01). There was a significant positive correlation between LD and weight and BMI (p < 0.01); There was a significant negative correlation between SD as well as LD with height (p<0.01). There was no correlation of age with SD and LD Conclusion: The brachial plexus should be encountered somewhere between 0.6-1.5 cm. Extra caution has to be applied if the brachial plexus is not encountered within 1 cm from the skin. In females, the plexus might be slightly deeper compared to males

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