A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

Abstract

Peripheral nerve blocks (PNB) are getting significant recognition for intraoperative and publish operative pain control because of their distinct advantage over general anaesthesia anesthesia. There are different ways to a brachial plexus block. The coracoid infraclavicular approach is feasible in almost all patients. A prospective randomized control trial was performed to compare the clinical effect of infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. Sixty patients receiving upper limb orthopedic surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The supraclavicular brachial plexus block was performed using nerve locater and ultrasound technique with 40 ml of 0.5% bupivacaine 1.5 mg/kg, ligocaine 2% with adrenaline 4mg/kg and distilled water. This study observed which nerve types were stimulated, and scored the sensory and motor blockage. The quality of the block was assessed intra-operatively and postoperatively with modified Lovette rating scale and McGill’s pain score. The duration of the sensory, motor block and the complications were assessed. The patient’s satisfaction with the anesthetic technique was assessed after surgery. In our study we observed similar effect in both infraclavicular and supraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach as complications are fewer with infraclavicular approach but expertise is needed in infraclavicular block.