Publication:

A comparison of two approaches to brachial plexus anaesthesia

Background A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulation technique for upper limb surgery.

Methods Eighty patients undergoing upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled into this study. The infraclavicular brachial plexus block was performed using the vertical technique (group I; N=40). The supraclavicular brachial plexus block was performed using the Kulenkampf technique (group S; N=40). In both the groups 30 ml of 0.5% ropivacaine was used as the local anaesthetic. The block performance time, the duration of onset of sensory and motor block was evaluated in both the groups S & I. The quality of the block & associated complications were also assessed.

Results A significant difference in the block performance time with comparable duration of onset of sensory was noted between the two groups S & I. Greater incidence of Horner’s syndrome was noted in group S.

Conclusions Supraclavicular brachial plexus block may be easier to perform than infraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications.