A comparative observe of infraclavicular and supraclavicular brachial plexus the usage of neurostimulation and ultrasound as additional tool

Authors : Sandip W Junghare, Minakshi S Junghare, Maya A Jamkar, Vipul K Sharma

DOI : 10.18231/j.ijca.2020.055

Volume : 7

Issue : 2

Year : 2020

Page No : 308-312

Peripheral nerve blocks (PNB) are getting significant recognition for intraoperative and publish operative
pain control because of their distinct advantage over general anaesthesia anesthesia. There are different
ways to a brachial plexus block. The coracoid infraclavicular approach is feasible in almost all patients.
A prospective randomized control trial was performed to compare the clinical effect of infraclavicular
and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. Sixty patients
receiving upper limb orthopedic surgery under infraclavicular or supraclavicular brachial plexus block were
enrolled in this study. The supraclavicular brachial plexus block was performed using nerve locater and
ultrasound technique with 40 ml of 0.5% bupivacaine 1.5 mg/kg, ligocaine 2% with adrenaline 4mg/kg and
distilled water. This study observed which nerve types were stimulated, and scored the sensory and motor
blockage. The quality of the block was assessed intra-operatively and postoperatively with modified Lovette
rating scale and McGill’s pain score. The duration of the sensory, motor block and the complications were
assessed. The patient’s satisfaction with the anesthetic technique was assessed after surgery.
Conclusions: In our study we observed similar effect in both infraclavicular and supraclavicular
brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach as
complications are fewer with infraclavicular approach but expertise is needed in infraclavicular block.

Keywords: Supraclavicular brachial plexus block, Upper limb surgery, lnfraclavicular brachial plexus block.


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