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. 2018 Jan-Mar;12(1):50-54.
doi: 10.4103/aer.AER_211_17.

Comparison of Ultrasound with Peripheral Nerve Stimulator-guided Technique for Supraclavicular Block in Upper Limb Surgeries: A Randomized Controlled Trial

Vinu Mervick Alfred  1 , Gnanasekaran Srinivasan  1 , Mamie Zachariah  1
Affiliations

Comparison of Ultrasound with Peripheral Nerve Stimulator-guided Technique for Supraclavicular Block in Upper Limb Surgeries: A Randomized Controlled Trial

Vinu Mervick Alfred et al. Anesth Essays Res. 2018 Jan-Mar.

Abstract

Background: The supraclavicular approach is considered to be the easiest and most effective approach to block the brachial plexus for upper limb surgeries. The classical approach using the anatomical landmark technique was associated with higher failure rates and complications. Ultrasonography (USG) guidance and peripheral nerve stimulator (PNS) have improved the success rates and safety margin.

Aims: The aim of the present study is to compare USG with PNS in supraclavicular brachial plexus block for upper limb surgeries with respect to the onset of motor and sensory blockade, total duration of blockade, procedure time, and complications.

Settings and design: Prospective, randomized controlled study.

Subject and methods: Sixty patients aged above 18 years scheduled for elective upper limb surgery were randomly allocated into two groups. Group A patients received supraclavicular brachial plexus block under ultrasound guidance and in Group B patients, PNS was used. In both groups, local anesthetic mixture consisting of 15 ml of 0.5% bupivacaine and 10 ml of 2% lignocaine with 1:200,000 adrenaline were used.

Statistical analysis: Independent t-test used to compare mean between groups; Chi-square test for categorical variables.

Results: The procedure time was shorter with USG (11.57 ± 2.75 min) compared to PNS (21.73 ± 4.84). The onset time of sensory block (12.83 ± 3.64 min vs. 16 ± 3.57 min) and onset of motor block (23 ± 4.27 min vs. 27 ± 3.85 min) were significantly shorter in Group A compared to Group B (P < 0.05). The duration of sensory block was significantly prolonged in Group A (8.00 ± 0.891 h) compared to Group B (7.25 ± 1.418 h). None of the patients in either groups developed any complications.

Conclusion: The ultrasound-guided supraclavicular brachial plexus block can be done quicker, with a faster onset of sensory and motor block compared to nerve stimulator technique.

Keywords: Nerve stimulator; supraclavicular block; ultrasound.

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Conflict of interest statement

There are no conflicts of interest.

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References

    1. Carty S, Nicholls B. Ultrasound-guided regional anaesthesia. Continuing Education in Anaesthesia Critical Care & Pain. 2007;1:20–4.
    1. Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: Failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg. 1999;88:847–52. - PubMed
    1. Brown DL, Cahill DR, Bridenbaugh LD. Supraclavicular nerve block: Anatomic analysis of a method to prevent pneumothorax. Anesth Analg. 1993;76:530–4. - PubMed
    1. Chan VW, Perlas A, Rawson R, Odukoya O. Ultrasound-guided supraclavicular brachial plexus block. Anesth Analg. 2003;97:1514–7. - PubMed
    1. Gaumann D, Forster A, Griessen M, Habre W, Poinsot O, Della Santa D, et al. Comparison between clonidine and epinephrine admixture to lidocaine in brachial plexus block. Anesth Analg. 1992;75:69–74. - PubMed