A COMPARATIVE STUDY BETWEEN BIER'S BLOCK AND SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB BELOW ELBOW SURGERIES

Abstract

Aim: To evaluate the onset of analgesia, degree of sensory and motor blockade, duration of analgesia and complications. Introduction: Brachial plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Intravenous Regional anaesthesia is a simple method of producing analgesia of the arm or leg by intravenous injection of a local anaesthetic, while the circulation is occluded.Materials And Methods:A prospective, randomised single-blinded study was undertaken in patients posted for upper limb below elbow surgeries. 80 patients aged 15-50 yrs with ASAclass I and II were randomly grouped into two groups. Group 1 – were anaesthetized by supraclavicular brachial plexus block. Group 2 – were anaesthetized by IVRA Results: Group II patients had a faster onset of action, grade I degree of sensory and motor blockade and lesser duration of action. Discussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also prolongs the duration thus provides better analgesia and reduces the requirements of rescue analgesics. Conclusion: IVRA appears to be a better alternative with regards to onset, quality of analgesia and degree of motor blockade. But the duration of analgesia is little more with Brachial plexus block