Stellate Ganglion Block vs Interscalene Brachial Plexus Block for Postoperative Analgesia among Patients Undergoing Surgery for Traumatic Upper Limb Fractures: Randomized Clinical Trial

INTRODUCTION: One of the common peripheral nerve blocks used for postoperative analgesia after upper limb surgeries is the Interscalene Brachial plexus block. use of a large volume of local anaesthetic can cause complications like peripheral neurologic injury, central nervous system (CNS) injury, pneumothorax, and phrenic nerve palsy.(1) Recently, there have been studies successfully using the stellate ganglion block for treatment of acute post operative pain with minimal side effects. OBJECTIVES: To compare pain intensity score among patients undergoing upper limb surgeries receiving either stellate ganglion block or interscalene brachial plexus block preoperatively within first 48 hours. MATERIALS AND METHODS: Patients of ASA physical status 1–2, aged between 18 and 60 years, with an upper limb fracture scheduled for surgery under general anaesthesia were included. Under standard ASA monitoring, pre-induction ultrasound guided interscalene block (IS group) or stellate ganglion block (SG group) was administered. Post-operative NRS scores, tramadol consumption, cardiovascular variables, sedation, nausea, vomiting, and any adverse effects were recorded.(2) RESULTS: 28 patients were recruited in eirher groups. Demographics and baseline vitals were similar in both the groups. There was a significant difference in NRS between the groups at 0 hours i.e. immediately after surgery with median NRS (4) in IS group compared to 3 in SG group. 9 subjects in IS group and 11 subjects in SG group required rescue analgesia in the form of bolus of Tramadol within 24 hours of the surgery. DISCUSSIONS/CONCLUSIONS: the stellate ganglion block provides comparable analgesia to interscalene brachial plexus block in upper limb surgeries.