International Journal of Medical Anesthesiology
2020, Vol. 3, Issue 2, Part A
Comparative study between nerve stimulator guided technique and ultrasound guided technique for supraclavicular nerve block in upper limb surgery- A randomized controlled trial
Author(s): Dr. Aditi Bhatnagar, Dr. Megha Tajne and Dr. Anjali Bhure
Abstract: Background and Aims– Ultrasonography guided supraclavicular block is presumed to have faster onset time and increased the success rates with a reduction of the local anaesthetic dose, and also low down the complication rates. Whether or not the use of USG can improve practitioner’s ability to successfully perform a faster supraclavicular nerve block remains needs to be studied. Hence study proposes to compare nerve stimulator guided technique and ultrasound guided technique for supraclavicular nerve block in upper limb surgery.
Methods- 60 adult patients, who were ASA physical status I–II and scheduled for elective upper limb surgery, were studied prospectively. 30 patients in each group to receive a supraclavicular block using either Ultrasound guidance (group U) or Nerve stimulation guidance (group P). Both the groups were injected with inj. Bupivacaine 0.5% 15ml and 2% lignocaine- with epinephrine 1:200000 15ml (total volume, 30 mL). The groups were compared in terms of Onset of sensory and motor block, Block performance time, Block success rate; hemodynamic parameters, and complications. Paired t-test and two-independent samples t-test were used for analysis. A p-value <0.05 was considered statistically significant for all comparisons.
Result- The mean block performance time for P group was 4.65 + 1.11 seconds while that of the U group was 3.41 + 0.88 seconds (p = 0.0001). The mean time of onset of sensory block was 9.45 + 3.21 minutes in P group versus 8.75 + 2.98 minutes in the U group (P = 0.4007). The mean time of onset of motor block was 10.65 + 2.62 minutes in P group versus 10.14 + 2.44 minutes in U group (p=0.4405). Block success was achieved in 25 patients in P group out of 30 (83.3%), while in U group, out of 30 only 2 patient did not achieve block success (93.3%) P = 0.68. The hemodynamic changes in the form of systolic and diastolic blood pressure, mean blood pressure, heart rate and oxygen saturation recorded every 5 min up to 30 minutes showed no significant difference.
Conclusion- Ultrasonography is a faster to perform, more accurate modality to perform the supraclavicular block.
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How to cite this article:
Dr. Aditi Bhatnagar, Dr. Megha Tajne and Dr. Anjali Bhure. Comparative study between nerve stimulator guided technique and ultrasound guided technique for supraclavicular nerve block in upper limb surgery- A randomized controlled trial. International Journal of Medical Anesthesiology. 2020; 3(2): 11-15. DOI: 10.33545/26643766.2020.v3.i2a.116