Comparison of Nerve Stimulator Guided Technique and Ultrasound Guided Technique of Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

Abstract

Background: Brachial plexus blocks provide a wonderful alternative to general anesthesia for upper limb surgeries. Among the various approaches of brachial plexus block, supraclavicular approach is considered easiest and effective. This study was designed to compare the nerve stimulator guided and the recently popularizing ultrasound guided technique for supraclavicular brachial plexus block with regards to time taken for the procedure, onset and duration of the block, success rate, overall effectiveness of the block and incidence of complications involved. Methods: We conducted a prospective, randomized, comparative study on 100 patients (50 in each group). We performed supraclavicular brachial plexus block by nerve stimulator technique in Group A and by ultrasound guided technique in Group B and compared the outcomes that followed. Primary outcome: duration of performing block. Secondary outcomes: time of onset of sensory and motor block, total duration of block, supplementation with general anesthesia, failure of block, complications associated. Results: The duration of performing block was 15.92 ± 3.03 min in Group A as compared to 8.04 ± 1.32 min in Group B, the p value being <0.001 (statistically significant). The mean time of onset of sensory block in Group A was 16.47 ± 4.05 min, whereas it was 14 ± 3.26 min for Group B, p value being 0.001 (statistically significant). The total duration of block, cases supplemented with general anesthesia, failure of blocks were comparable among the two groups. There was no complication in either group. Conclusion: The ultrasound guided technique offers advantage over nerve stimulator guided technique by significantly reducing the duration of performing block and time of onset of sensory block.