Lateral approach versus conventional approach supraclavicular block for forearm surgeries. A prospective randomized controlled study

Conventional technique of supraclavicular block is associated with direct injury to the vessels, nerves and pleura, which can be minimized with lateral approach. Here, we compared lateral with conventional approach supraclavicular block given for forearm surgeries.

After getting approval from ethical scientific committee, SSG hospital, Vadodara, this randomized prospective single blinded study was conducted from October 2014 to October 2015. 60 patients of either gender between 18 to 60 years, of ASA grade I and II undergoing forearm surgeries were enrolled. Those who refused, having anatomical distortion or infection of local site and pregnant patients were excluded. After doing randomization by computer method, Group C (n=30) received conventional and Group L (n= 30) received lateral approach supraclavicular block using nerve locator and total 35 ml of Inj. Lignocaine with adrenaline (1: 200000)7mg/kg, Inj. Bupivacaine 2 mg/kg with Inj. Sterile water was injected. Patients were evaluated for technical difficulty, characteristics of sensory and motor blockade, duration of postoperative analgesia and complications.

Statistical analysis was done using student ‘t’ test with Medcalc software. P<0.05 was considered statistically significant. Supraclavicular block through lateral approach was easy to perform as less number of attempts were required. The characteristics of the sensory and motor block as well as duration of analgesia was similar in both the groups and incidence of vascular puncture was nil with lateral approach.

Lateral approach of supraclavicular block is a safe alternative to conventional approach.