Comparative study of different techniques used in interscalene brachial plexus block in adult upper limb surgeries

Abstract

Background and aim Brachial plexus block remains a practical alternative to general anesthesia for significant surgery on the upper limb. It offers a superior quality of analgesia and prevents the common adverse effects related to general anesthesia. We aimed to compare the different techniques used for interscalene brachial plexus block with regard to success rate, duration of analgesia, patient satisfaction, and incidence of complications. Patients and methods This study was carried out in Al-Azhar University Hospitals (Assiut) on 80 patients scheduled for upper limb surgeries who were randomly divided into four groups, each group with 20 patients. Results Block execution time was significantly lower in the ultrasound (US) group than in other groups. As regards the time of onset of sensory block, it was significantly lower in the combined nerve stimulator (NS) and US group (NU group) than the conventional blind group (CB group). The time of onset of motor block was significantly lower in the US group and NU group than the CB group. Comparing the groups regarding the duration of analgesia, it was significantly higher in the US group and NU group than the CB group and was significantly higher in the NU group than the NS group alone. The number of needle punctures was significantly lesser in group NU than in group CB. Conclusion US-guided technique allows for the direct visualization of the nerves, the needle tip itself, and the spread of the local anesthetic in the desired location. The US image reliably depicts other structures, such as blood vessels and lungs, that we want to avoid.

Keywords

• block
• brachial
• interscalene
• plexus
• surgeries
• upper limb