A comparative study between supraclavicular brachial plexus block and Infraclavicular brachial plexus block for upper limb orthopedic surgeries: A prospective, randomized, double-blind study

Abstract

Introduction: Supraclavicular brachial plexus block is a common approach as it provides faster and dense blockade. In the past few years, infraclavicular brachial plexus block has become a method of increased interest as it has a lower complication rate and near to equal efficacy. The goal of this study was to compare block performance time, block characteristics, quality of block, patient's satisfaction, and complications between infraclavicular and supraclavicular techniques for brachial plexus block. Patients and methods: 100 subjects were randomized in a doubleblind fashion, to receive either an infraclavicular block (Group I, n=50) or supraclavicular block (Group S, n=50) using nerve locator apparatus. Block performance time, onset, peak, duration of sensory and motor blockade, any change in hemodynamics, complications were recorded at scheduled intervals intra-operatively and post-operatively as per study protocol. Data were analyzed using GraphPad INSTAT version 3.06 software by Chi-square test or Mann-Whitney U test to compare categorical variables. Results: The block performance time was faster in the Group S compared to the Group I (4.8±4.4 minutes vs. 6.3±1.39 minutes, p <0.001). The sensory block onset time was faster in Group S compared to the Group I (6.9±1.58 minutes vs. 7.6±1.34 minutes, p=0.019). Other observed variables were considered statistically not significant. Conclusion: From our study, it is inferred that nerve locator guided Infraclavicular block by a vertical coracoid approach using multineurostimulation method is less rapidly executed as nerve locator guided supraclavicular block with a similar degree of surgical anesthesia and lesser complication rate.Keywords: supraclavicular block, infraclavicular block, nerve stimulation, comparison. Cite This Article: Sarkar, S., Doshi, S.M. 2019. A comparative study between supraclavicular brachial plexus block and Infraclavicular brachial plexus block for upper limb orthopedic surgeries: A prospective, randomized, double-blind study.

A Comparison Between Ultrasound-Guided Supraclavicular and Infraclavicular Approaches to Brachial Plexus Block for Elective Upper Limb Surgery

“…This finding contrasts with the studies conducted by Abhinaya et al, Koscielniak-Nielsen et al, and Gurkan et al, in which they reported that block performance time was less in the infraclavicular block when compared to the supraclavicular block. However, a study conducted by Sarkar et al reported similar findings as our study [ 1 , 3 - 5 ]. This might be due to the unfamiliarity of the methodology and relative technical difficulty in performing infraclavicular brachial plexus block.…”

“…Regional anaesthesia is used widely nowadays, owing to its multiple advantages when compared to general anaesthesia. There is increasing evidence showing that regional anaesthesia produces a good reduction in postoperative pain, side effects, and intraoperative and postoperative morbidity, which in turn results in shorter stays in postoperative anaesthesia care [ 1 , 3 - 5 ]. In our study, a comparison of the supraclavicular and infraclavicular approach to the brachial plexus was carried out, which indeed is one of the fewer studies conducted in this part of the country to decipher and compare the effects of infraclavicular and supraclavicular blocks.…”