Our Experience in Supraclavicular Brachial Plexus Block by Ultrasonography compared with Conventional Method in Upper Limb Surgeries

Ultrasound allows direct visualization of peripheral nerves, the block needle and local anesthetic disribution. The conventional technique of supraclavicular brachial plexus block being a blind technique may be associated with higher failure rates and injury to nerves and vascular structures, intravascular injection of local anesthetic agent, and injury to dome of pleura and pneumothorax. Hence Ultrasound (USG) is the method offering safe block of superior quality by optimal needle positioning.

This study was conducted among 60 patients posted for elective upper limb surgery of ASA I and II. In one group (n=30) ultrasonography(USG) guided technique was used and in second group (n=30) elecitation of paresthesia technique was used. Various parameters including procedure time, onset time for sensory block, duration of sensory block, onset time for motor block, duration of motor block, time to achieve complete block and any complications etc were observed.

Overall success rate was higher in USG guided group as compared to conventional method group, which was statistically significant (p <0.05). Time to perform the block was significantly shorter in USG guided group (p <0.05). Onset time for sensory block, onset time for motor block & time to achieve a complete block was also shorter in USG guided group (p value <0.05). Duration of sensory & motor block was significantly prolonged in USG guided group (p <0.05)

Ultrasonography guided supraclavicular brachial plexus block is quick to perform, offers improved safety & accuracy in identifying the position of the nerves to be blocked with higher success rates.