Comparison of Lateral Approach With Conventional Approach of Supraclavicular Brachial Plexus Block: A Prospective Randomized Comparative Study

Traditionally Supraclavicular Brachial plexus block is the commonly performed block for upper extremity surgeries. The Problems associated with this technique include inadequate block, failed block, direct injury to the nerves, pneumothorax, phrenic nerve palsy and vascular puncture etc. Recently lateral approach for supraclavicular brachial plexus block is gaining popularity because of its less complications and high success rate. The aim of the study is to compare the efficacy of lateral approach with conventional approach for supraclavicular brachial plexus block. METHODS: Fifty patients of ASA grade I and II scheduled for upper extremity surgery (below the midarm) were randomly allocated into two groups of 25 each. Group C was randomly allocated to receive supraclavicular brachial plexus block by conventional approach. Group L was randomly allocated to receive supraclavicular brachial plexus by lateral approach. Both the groups were given 10ml of 1.5% lignocaine and 15ml of 0.5% ropivacaine (total volume 25 ml).The parameters assessed were the onset and duration of sensory and motor blockade, time taken for the procedure, need for supplementation of anaesthesia, adverse effects, tourniquet tolerance and success rate. Statistical analysis was done using appropriate tests, (p<0.05) was considered statistically significant. We concluded that lateral approach for supraclavicular brachial plexus block using peripheral nerve stimulator, is a better alternative to conventional approach in terms of higher success rate and lesser complication rate.