A Comparative study on the approaches to Brachial Plexus blocking in a Teaching hospital

Dr. Sunil Kumar Jain; Dr. Sudhir Tichkule

Volume : VIII, Issue : IX, September - 2019

A Comparative study on the approaches to Brachial Plexus blocking in a Teaching hospital

Dr. Sunil Kumar Jain, Dr. Sudhir Tichkule

Abstract :

Introduction : Supraclavicular Brachial plexus block is the commonly performed block for upper extremity surgeries. But this technique also includes inadequate block, failed block, direct injury to the nerves, pneumothorax, phrenic nerve palsy and vascular puncture etc. A lateral approach for supraclavicular achial plexus block is also becoming popular. The aim of the study is to compare the efficacy of lateral approach with conventional approach for supraclavicular achial plexus block. METHODS: Fifty patients of ASA grade I and II scheduled for upper extremity surgery (below the midarm) were randomly allocated into two groups of 25 each. Group C was randomly allocated to receive supraclavicular achial plexus block by conventional approach. Group L was randomly allocated to receive supraclavicular achial plexus by lateral approach. Both the groups were given 10ml of 1.5% lignocaine and 15ml of 0.5% ropivacaine (total volume 25 ml). The parameters assessed were the onset and duration of sensory and motor blockade, time taken for the procedure, need for supplementation of anaesthesia, adverse effects, tourniquet tolerance and success rate. Statistical analysis was done using appropriate tests, (p<0.05) was considered statistically significant Results :. 50 patients were enrolled for this study. All the patients completed the study. Paraesthesia was elicited in all the patients using nerve stimulator. The mean times to onset of sensory and motor blockade were comparable in both the groups [(p>0.05). The mean duration of sensory and motor blockade also did not differ between the two groups (P>0.05, statistically not significant. The mean duration of analgesia also did not differ between the two groups , statistically not significant. Conclusion : We concluded that lateral approach for supraclavicular achial plexus block using peripheral nerve stimulator, is a better alternative to conventional approach in terms of higher success rate and lesser complication rate.