A Comparative Study of Different Techniques of Brachial Plexus Block in Upper Limb Surgery

Abstract

Background: Different techniques of Brachial Plexus block in upper limb surgery depending on the site of operation the approach of the brachial plexus was chosen. For the operations around the shoulder joint interscalene approach was chosen; for the operations up to the shoulder either interscalene or supraclavicular or Infraclavicular routes were chosen and for the operations up to and around the elbow joint any one of the four approaches were tried. Objective of this study was to evaluate its clinical applications and practical utility in providing good analgesia for the upper extremity surgery in elective as well as emergency cases.Design: This was a hospital based retrospective study. Duration: One Year i.e. from June 2018 to June 2019. Participants: 80 patients.Subjects and Methods:The present study includes 80 blocks of brachial plexus by four different routes. 1. Supraclavicular approach – 20 cases. 2. Infraclavicular approach – 20 cases. 3. Axillary perivascular approach – 20 cases. 4. Interscalene – 20 cases. The cases were selected at random, who were subjected for various types of surgery of upper extremity both elective and emergency as in-patients.Results:In this series of 80 blocks, when the type of the surgery (emergency or elective) is considered, it has been that about one third of the patients underwent emergency surgery successfully with the brachial plexus block. In the remaining two-third of the patients, the surgery was planned procedure.Conclusion:Thus, our study reveals that the brachial plexus block can be equally safely employed for emergency surgery as for any elective procedure. Some-times the brachial plexus block can be the only choice with no alternatives affording a reasonable chance to a moribund patient to undergo emergency surgery. The dosage of the drug was modified according to the patient’s general condition.