Original Research Article
Year: 2020 | Month: October-December | Volume: 5 | Issue: 4 | Pages: 1-13
A Comparative Study of Quality of Ultrasound Guided Supraclavicular and Infraclavicular Blocks for Upper Limb Surgery
Abik Mallik1, Krishnendu Chandra2
1Dept. Of Anaesthesiology, Burdwan Medical College, Burdwan, WB
2Associate Professor, Dept of Anaesthesiology, RKMSP, VIMS, Kolkata,WB
Corresponding Author: Krishnendu Chandra
ABSTRACT
Introduction: Ultrasound-guided supraclavicular and infraclavicular brachial plexus blocks are commonly used for upper extremity surgery. Infraclavicular block appears to have a better quality of block and less side effects.
Aim: To compare efficacy of ultrasound guided Supraclavicular and Infraclavicular brachial blocks for upper limb surgery using Ropivacaine 0.5%.
Method: 120 male and female patients aged 18-80 years, of ASA 1 & 2 undergoing upper limb surgery under ultrasound guided Supraclavicular or Infraclavicular blocks were randomized in 2 groups (60 each). Under standard monitoring brachial block was administered to all patients. Group S received ultrasound guided supraclavicular and group I received infraclavicular brachial plexus blocks using Ropivacaine 0.5% , making upto a volume of 0.5 ml/kg (Maximum volume 40ml, Maximum dose-3mg/kg). Hemodynamic parameter, quality and duration of sensory and motor blockade, duration of analgesia, VAS score, side effects (pneumothorax, accidental vascular puncture, suspected diaphragmatic paresis and Horner’s syndrome) were noted at specified intervals.
Results: Demographic variables, duration and type of surgery, hemodynamic parameter, respiratory parameters, block performance time and block performance related pain were comparable at all time interval between two groups. In I group higher proportion of patient achieved sensory and motor block of ulnar(p<0.05) and median nerve at 30 minute after completion of block than S group. More patient in I group was ready for surgery at 30 minute than S group. More patients in S group required surgical anesthesia supplementation than I group(p<0.05).Regarding duration of sensory block, motor block and duration of analgesia, USG guided supraclavicular block was superior. More patients of Group S suffered side effects than group I.
Conclusion: Compared to USG guided supraclavicular block, Ultrasound-guided infraclavicular brachial plexus block provides superior surgical anesthesia with less side effects but with less duration of analgesia.
Keywords: Supraclavicular block, Infraclavicular Block, Ropivacaine