Efficacy of supraclavicular brachial plexus block by using USG guided method versus peripheral nerve stimulator guided method: A comparative study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: Regional blocks offer several advantages over general anaesthesia. Supraclavicular approach to brachial plexus block is the preferred regional anaesthesia for upper limb surgeries they achieve ideal operating conditions by producing complete muscular relaxation, maintaining stable intraoperative hemodynamic, and the associated sympathetic block. The sympathetic block decreases postoperative pain, vasospasm and edema.Aim and objectives: To study the efficacy of supraclavicular brachial plexus block by using USG guided method versus peripheral nerve stimulator guided method. Materials and Method: The present study conducted on 100 patients admitted for elective upper limb surgeries belonging to American Society of Anaesthesiologists (ASA) Grade I and II of either sex from 18 to 50 years of age. The selected patients were allotted in two groups by using randomization technique. Group USG (Ultrasound guided): received USG supraclavicular brachial plexus block using inj.bupivacaine 0.25% and Group PNS (Peripheral nerve stimulator): received supraclavicular brachial plexus block using PNS and using inj.bupivacaine 0.25%. All the patients underwent thorough pre-anaesthesia evaluation on the day prior to the surgery. The time taken for the procedure, the onset of sensory blockade and motor blockade were noted. Intra-operatively, hemodynamics were monitored at regular intervals. Following completion of surgery, the patients were monitored to assess the quality and duration of post-operative analgesia. At the time of each subsequent assessment, patients were observed and/ or questioned about any subjective and/or objective side effects (sedation, nausea, vomiting or respiratory depression, neurological injury).Results: The mean time taken for the procedure to administer the block by using an ultrasound was 14.08 ± 5.09 minutes, whereas by using Peripheral nerve stimulation was 9.76 ±3.45 minutes and the difference observed was statistically significant. The mean time of onset of sensory block and motor block in both the groups was not statistically significant. Similarly difference in mean duration of sensory block and duration of motor block in both the group was not significant. The block was successful in 84% of patients in group USG as compared to 74% in group PNS. But the difference observed was not statistically significant (P>0.05).Intra-operative complication like vessel puncture were more in PNS group (14%) than USG group (4%). Conclusion: Thus we conclude that the success rate and effective quality of the block were more with ultrasound group than peripheral nerve stimulator group. But time taken for the block performed by ultrasound was longer than the peripheral nerve stimulator technique which means expertise is required to administer and use ultrasound machine. The incidence of complications like vessel puncture was seen more in peripheral nerve stimulator technique as compared to ultrasound group.
Authors and Affiliations
RavirajShivajirao Pol, Abhimanyu Tarkase
Keywords
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- EP ID EP616654
- DOI 10.26611/101510213
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