Usefulness of ultrasound-guided infraclavicular brachial plexus block: a comparison with nerve stimulation method

Abstract

Background: Recently, ultrasound guidance in clinical procedures including brachial plexus block has gained popularity. This method has been considered to be an efficient and a useful method with real-time visualization. Many reports have showed the usefulness of ultrasound-guided brachial plexus block. We evaluated the usefulness of ultrasound guidance in infraclavicular brachial plexus block compared with nerve stimulation. Methods: Thirty patients were randomized into two groups of US group (ultrasound-guided block) and NS group (nerve stimulation). Blocks were performed with mepivacaine 2% and bupivacaine 0.5% with epinephrine 1：200,000 (total volume 40ml). Block execution time, onset time, success rate, patient`s discomfort and complications were measured and statistically evaluated for the comparison. Results: Block execution time were 88.3±48.1 sec in US group and 172.7±103.1 sec in group NS, respectively (P=0.017). Onset time were 16.0±6.9 min and 17.7±7.8 min (P=0.434). Success rates were 93.3% and 80.0% (P=0.283). Patient`s discomfort was not significantly different. Pain in patients with fractured arm was significantly lower in US group (P=0.004). Conclusions: An ultrasound-guided infraclavicular brachial plexus block is useful with less time consumption and less discomfort in patients with fracture of arm. Success rate and onset time were acceptable. (Korean J Anesthesiol 2008; 55: 436∼40)