Original Research Article
Year: 2021 | Month: January-March | Volume: 6 | Issue: 1 | Pages: 21-26
Peripheral Nerve Stimulator (PNS) Versus Trans-Arterial (TA) Techniques for Axillary Brachial Plexus Block
Sunil Kumar Sah1, Tofazzel Haque Sahana2, Sekhar Ranjan Basu3
1Assist. Professor, North Bengal Medical College; Darjeeling, West Bengal, India.
2SR, Department of Anaesthesiology; North Bengal Medical College; Darjeeling, West Bengal, India.
3HOD, North Bengal Medical College; Darjeeling, West Bengal, India.
Corresponding Author: Tofazzel Haque Sahana
ABSTRACT
Background: Axillary brachial plexus block is one of the widely used techniques for upper extremity surgery. Peripheral nerve blocks (PNB) provide optimal surgical conditions while providing prolonged post-operative analgesia. The transarterial (TA) technique of axillary brachial plexus block is a well established method of producing regional anaesthesia for surgeries at or below elbow. In this prospective randomized study we compared, “peripheral nerve stimulator (PNS) versus trans-arterial (TA) techniques for axillary brachial plexus block”
Methods: In this prospective, randomized study 80 patients, age>18 year, ASA-I & II, were divided randomly into two groups PNS and TA. In PNS groups 40 patients received axillary approach of brachial plexus block with the help of peripheral nerve stimulator, and rest TA group received axillary block through transarterial approach. Local anaesthetic 0.25% bupivacaine 15ml+1% lignocaine with adrenaline (1:200,000) 20 ml was used. Then success rate of two different methods of block were compared. Other parameters of comparison was block performance time of block, onset of sensory and motor block, failure rate, analgesia required etcetera.
Results: The success rate of the block in PNS group was 90% and the success rate of TA group was 85% and there was no significant difference in success rate. Performance time was significantly low in trans-arterial axillary approach of brachial plexus block (p<0.005). There was no significant difference in onset of motor and sensory block. The sensory and motor functions returned properly in all patients.
Conclusion: In our study we found that the PNS guided axillary block and TA injection axillary brachial plexus block provide similar success rate, and onset of block when musculocutaneous nerve blocked separately in the both techniques.
Keywords: Axillary brachial plexus block, Trans-arterial approach, Peripheral nerve stimulator.