MVP Journal of Medical Sciences

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


Affiliations

  • Dr. Vasantrao Pawar Medical College Hospital & Research Centre, Department of Anaesthesia, Nashik, Maharashtra, 422003, India

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.

Keywords

Brachial Plexus Block, Nerve Stimulator, Paresthesia

Full Text:

References

Moore D. Supraclavicular approach for block of the brachial plexus. Moore D, editor. Regional block. A handbook for use in the clinical practice of medicine and surgery. 4th ed.Springfield: Charles C Thomas Publisher; 1981.p. 221–41.

Labat G. Regional anaesthesia. Its technic and clinical application.Philadelphia: WB Saunders Company; 1922.

Winnie AP. Historical consideration. Plexus Anaesthesia.1984; 1:43–116,192–202.

Liguori GA, Zayas VM, Ya Deau JT. Nerve localisation techniques for interscalene brachial plexus blockade: A prospective, randomised comparison of mechanical paresthesia versus elec-trical stimulation.

Chapman GM. Regional nerve block with the aid of a nerve stimulator. Anesthesia. 1972; 27:185–93. https://doi.org/10.1111/j.1365-2044.1972.tb08195.x

Sathyan N, Hedge H, Padmanabha S, Anish KA. Brachial plexus Block: A Comparison of Nerve locator versus paraesthesia technique. Journal of Dental and Medical Sciences.2014; 13(1):6–10. https://doi.org/10.9790/0853-131100610

Liguori GA, Zayas VM, YaDeau JT, Kahn RL, Paroli L, Buschiazzo V, Wu A. Nerve localiza-tion techniques for interscalene brachial plexus blockade: A prospective, randomized comparison of mechanical paresthesia versus electrical stimulation. Anesthesia and Analgesia.2006 Sep 1; 103(3):761–7. https://doi.org/10.1213/01.ane.0000229705.45270.0f PMid:16931693

Franco CD, Vieira ZE. 1,001 subclavian perivascular brachial plexus blocks: Success with a nerve stimulator. Regional Anesthesia and Pain Medicine. 2000 Feb 29; 25(1):41–6.https://doi.org/10.1097/00115550-200001000-00008

Baranowski AP, Pither CE. A comparison of three methods of axillary brachial plexus anaesthe-sia. Anaesthesia. 1990 May 1; 45(5):362–5. https://doi.org/10.1111/j.1365-2044.1990.tb14776.x PMid:2356931

Bansal P, et al. Comparison of interscalene brachial plexus blockade by eliciting multiple point paresthesia and electrical nerve stimulation techniques: a prospective, randomized trial. The In-ternet Journal of Anesthesiology. 2009; 23(2):1–6.

Masoud NG, Taghi MM, Reza MG, Maarouf A, Seyedabolhasan S, Naser G. Complications of supraclavicular block of brachial plexus using compound classic and perivascular techniques. Rawal Med J. 2007 Jan; 32:60–2.


Refbacks

  • There are currently no refbacks.