Ultrasound guidance versus nerve locator for infraclavicular brachial plexus block: a comparative clinical study

Noor El-Din, Tawfik M.; Abd-Elslam, Yousry M.; Saleh, Abd-Elwahab A.; Makled, Ahmed M.

doi:10.4103/sjamf.sjamf_8_18

Ultrasound guidance versus nerve locator for infraclavicular brachial plexus block: a comparative clinical study

Authors

Abstract

Background
The use of ultrasound (US) guidance for nerve blocks has dramatically increased over the past 20 years. The success rate of infraclavicular block is improved by US guidance compared with nerve locator (NL).
Aim
In this study, we aimed to compare conventional block using NL and US-guided techniques in the infraclavicular approach to the brachial plexus for upper limb surgeries (forearm and hand surgeries, either elective or emergency).
Patients and methods
The study was carried out on 40 adult patients of both sexes who were randomly classified using closed envelope method into two equal groups, with 20 patients each: All patients undergoing either conventional block using NL or US-guided block were premedicated with 0.02 mg/kg of midazolam. The technique was done by identification and blocking the cords of brachial plexus by administration of 15-ml 0.5% bupivacaine and 15-ml of 2% lignocaine with adrenaline 1 : 200 000 in both groups. Onset of the block, success rate, patient satisfaction, and the complications were recorded.
Results
Sensory and motor block onset times were shorter in group B than in group A. The success rate and patient satisfaction were more in group B than in group A. Patients in group B had fewer complications than in group A.
Conclusion
To conclude, our results showed less time to perform ICBPB in group B and the onset of complete block as well as high success rate, patient satisfaction, and fewer incidences of complications.

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