A randomized comparative study on brachial plexus block using nerve stimulator: infraclavicular-coracoid approach vs supraclavicular approach release_dtacclcrcrdkpn6r7j5wjdop6q

by A Kumar, N Madhava Krishna, V Karthik, S Mahalakshmi

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Introduction: Pain relief with peripheral nerve block (PNB) is devoid of side effects such as somnolence, nausea, vomiting, hemodynamic instability and voiding difficulties inherent to general and central neuraxial anesthesia. Aim: To compare the clinical efficacy of infraclavicular and supraclavicular approach of brachial plexus block by using peripheral nerve stimulator. Materials & Methods: Sixty patients of ASA grade I and II undergoing upper limb surgeries were randomly assigned into two groups, Group I and Group S group I: received infraclavicular block by coracoid approach, group S: received Supraclavicular block. Surgeries below the level of elbow were selected for this study. Parameters observed were-block performance time, sensory and motor blockade, and its quality, duration of post op analgesia, and block related complications. Results: Time to perform block, onset of both motor and sensory blockade, duration of post op analgesia were not different in group I and Group S. Success rate of blocking four nerves to the elbow (musculocutaneous, ulnar, radial, median,) was comparable between the groups. The incidence of complications in the form of vascular puncture was not significant in both group I and Group S. Conclusion: From our study it is inferred that nerve locator guided Infraclavicular block of brachial plexus by coracoid approach is at least as rapidly executed as nerve locator guided Supraclavicular approach and produces a similar degree of surgical anaesthesia with similar complication rates.
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