Comparison of Ultrasound Guided Supraclavicular Block and Costoclavicular Block for Forearm and Hand Surgeries.

Abstract

BACKGROUND: Effective brachial plexus blocks depend on accurate methods of nerve location, needle placement,local anesthetic. An emerging technique for procedures on the upper limb surgeries is costoclavicular approach to infraclavicular brachial plexus block. Utilizing ultrasound guided technique in both approaches, this study aids in comparing the block properties and the incidence                    of diaphragm involvement.

MATERIALS AND METHODS:For forearm and hand surgeries, 50 patients with ASA physical status 1, 2, and 3 were  enrolled. A supraclavicular block (20 ml of 0.75% ropivacaine and 8 mg of dexamethasone) will be administered to one group, while a costoclavicular block of the same drug concentration will be administered to other group. After the procedures, the two groups differences in analgesia duration, onset of motor and sensory blockade, block performance time, and hemi diaphragmatic paralysis were compared and analyzed using data analysis.

RESULTS: In our study, it was found that the two groups motor blockage onset were comparable. In comparison to the supraclavicular group, the costoclavicular group that received ropivacaine experienced significantly longer analgesia duration. The hemodynamic parameters weren't significantly different between the two groups. When compared to supraclavicular block, the costoclavicular block significantly reduced the risk of hemidiaphragmatic paralysis during forearm and hand procedures.

CONCLUSION: According to this study, as compared to the ultrasound guided supraclavicular approach of blockade for forearm and hand procedures, the costoclavicular block technique has a faster onset of sensory blockade, a lower incidence of hemi diaphragmatic paralysis, and a longer duration of analgesia.