Comparison of Success Rate of Classical Supraclavicular Brachial Plexus Block with and without Nerve Stimulator

Abstract

Introduction: Brachial plexus block has now evolved into valuable and safe alternative to general anesthesia for upper limb surgeries. The nerve stimulation technique make use of electric current to elicit motor stimulation of nerves and confirm the proximity of the needle to the nerve, thereby avoiding the discomfort caused due to paresthesia leading to good success rate, even when the pa-tient is uncooperative or uncommunicative. Aim and Objectives: To compare between paresthesia technique and use of nerve locator in performing supraclavicular brachial plexus block with respect to success and complication rate. Materials and Methods: A comparative study was conducted at department of Anesthesia of a tertiary care centre. A total of 100 patients undergoing upper limb elective surgery were included after satisfying inclusion and exclusion criteria. The anesthetic method employed was Brachial plexus block by Supraclavicular Approach: using paresthesia technique (Group A: 50 subjects) and; by using Nerve Stimulator technique (Group B: 50 subjects). Both the groups of patients were studied for performance time, sensory block, and motor block and for success rate. Statistical analysis was done using SPSS ver. 21. Results: Onset of sensory and motor block were significantly faster in nerve stimulator group as compared to paraesthesia group (p<0.05), also the duration of block was more in nerve stimulation group (7.28 vs 6.54 hrs; p-0.057). Failure of block was seen in 22% patients with paraesthesia technique as compared to 14% with nerve stimulation (p-0.44). No difference was observed between the groups on the basis of complication rate (10% vs 2%; p-0.2). Conclusion: Onset of sensory and motor block was shorter and duration of analgesia was longer with nerve stimulation group. Nerve stimulation was found more effective than paraesthesia with respect to degree of success and complication rate.