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Superior Ultrasound Guided Technique for an Effective Supraclavicular Block in Upper Limb Surgery

Avinash Sharma

Context: Supraclavicular approach gives an effective block of brachial plexus with fast onset and complete block.

Aims: To analyse and compare the efficacy, safety and complications in performing supraclavicular brachial plexus nerve blocks by Peripheral Nerve stimulator (PNS) and Ultra Sound (US) guidance techniques.

Settings and design: A prospective and randomized comparative study.

Materials and methods: Patients were randomized into two groups, Group US and Group PNS consisting of 80 patients each. The amount of local anaesthetic used was 20 ml 0.5% bupivacaine + 10 ml normal saline for both the groups.

Statistical analysis used: The data from the customized proforma was analysed by using t-test, Z-test and Chi-square test.  A p-value of less than 0.05 was considered statistically significant.

Results: The time to perform the supraclavicular brachial plexus nerve block was shorter in group US than in group PNS. The onset of sensory and motor block occurred earlier in the group US compared to the group PNS. The duration of block (sensory and motor) and analgesia was longer for the group US than for the group PNS.

Conclusion: Owing to real-time visualization and precise deposition of drug around the plexus, the quality of supraclavicular brachial plexus block was better for the patients in group US than group PNS.