Brachial Plexus Anaesthesia: A Comparative Study on Supraclavicular Subclavian Perivascular Technique with the Axillary Transarterial Technique with A Tourniquet

Abstract

Objectives : To make a comparative evaluation of efficacy of brachial plexus blockade between supraclavicular subclavian perivascular technique and axillary transarterial technique with a tourniquet and also to compare the latency & potency of the block, to ascertain the risks of complications between the techniques and to compare the haemodynamic stability of the patient. Methods : For this purpose a total of 100 undergoing surgery for distal to the midarm. They were randomly selected by odd and even numbering method. These patients were divided into two groups (Group A: subclavian perivascular supraclavicular technique bearing all the odds numbers and Group B: transarterial axillary technique with a tourniquet bearing all the even numbers; fifty patients in each group. Results : The only exception is the mean on set time of sensory block was 11.0±2.6 minutes and 14.3±2.1 minutes in Group A and Group B respectively. The mean on set time of motor block were 18.3±3.9 minutes in Group A and 21.4±3.2 minutes in Group B. So the mean on set time of sensory block and motor block were statistically significant (p<0.05). Most of the patients found complete sensory block and complete motor block between two groups and no significant (p>0.05) difference was found in the present study. Adequate efficacy of block were predominate in both groups and no significant (p>0.05) difference was found. The level of satisfaction of surgeon and it was found that 92.0% in Group A and 94.0% in Group B were satisfied. Patient's co-operation was found 92.0% and 94.0% in Group A and Group B respectively. No significant (p>0.05) difference were found in terms of surgeon satisfaction and patients cooperation between two groups. Conclusion : It can be concluded that the supraclavicular subclavian perivascular technique and axillary transarterial technique with a tourniquet both are equally effective and safe method for providing brachial plexus block distal to midarm (Lower half of the arm, elbow, forearm and hand).

Ultrasound Guided Axillary Brachial Plexus Block Versus Supraclavicular Block In Emergency Crushed Hand Patients : A Comparative Study

“…Roshid and others reported that the incidence of pneumothorax with SCB was about 6.1%. They concluded that the incidence of complications following brachial plexus block is low but it's much more common with SCB than AXB, this was also stated by Arnuntasupakul et al, and they advised to avoid SCB if there is pulmonary dysfunction [11,19].…”

“…On the other hand, Axillary block, which has a success rate up to 100% due to ultrasound guidance, easier identification of the block in an obese patient, very safe, easy to be done and reported to be the least one of the brachial plexus approaches to have complications [19]. Although it needs more needling and performance time to be performed and subsequently more anesthesia-related time.…”