Comparison of infraclavicular block and axillary block activities performed in ultrasonography coexisting in upper extremity surgery

Abstract

Aims: Infraclavicular and axillary block performed with ultrasound guidance are effective peripheral anesthesia methods applied in upper extremity surgery. We aimed to compare these methods in terms of duration of the block and action, first analgesic requirement and side effects.
 Methods: This prospective, randomized study was conducted for upper extremity surgery. 100 patients were included to perform infraclavicular block (Group 1, n=51) and axillary block (Group 2, n=49) USG guided. Patients are between 19 and 85 years old. Both groups were premedicated with 0.3 mg/kg midazolam or 0.5-1 μg/kg fentanyl. Both groups were treated with a mixture of local anesthetics in a total volume of 30 mL [7.5 mL 0.5% bupivacaine (Bustesin®, 56.25 mg), 7.5 mL 2% prilocaine (Priloc®, 225 mg) and 5 mL saline] was injected. Block placement time, motor and sensory tests, postoperative 2nd, 4th, 8th, 12th. and analgesic requirement at the 24th hour, Bromage scale, Verbal Rating scale, nausea vomiting, patient satisfaction, and block adequacy data were recorded.
 Results: In this study, 60% of the participants included were male and 40% were female. The systolic, diastolic and mean arterial pressures were higher in group of axillary blockade than those with blockade of infraclavicular blocks. Radial, median, ulnar and musculocutaneous nerve pin-prick test loss and loss of touch test was more frequent in infraclavicular block patients. According to the Bromage scale, the partial block was seen more frequently in patients who had a close block and a full block infraclavicular block. In patients with the axillary blockade, sedoanalgesia and general anesthesia needs after postoperative intraoperative 20 min and postoperative sedoanalgesia was needed. According to the postoperative Bromage scale; complete and close to the thumb and more frequent in infraclavicular block patients. In Postop VRS, it was observed that the patients with the axillary block group had mild, moderate, and severe pain complaints. Patient satisfaction in the postoperative period was similar in both groups.
 Conclusion: There is no significant difference between these techniques regarding surgical adequacy and subjective postoperative analgesia and dysesthesia. Complete and near-complete block rates in the infraclavicular block approach are minimally higher than in the axillary block approach.