Key result
Ultrasound guidance cuts brachial plexus block time by ~48% and improves success vs nerve stimulator.
Why the study?
Peripheral nerve blocks can be performed by several methods, prompting a comparison between peripheral nerve stimulator and ultrasound-guided supraclavicular block for upper limb orthopedic surgeries in an Indian population.
Does ultrasound-guided supraclavicular brachial plexus block improve block success and reduce execution time compared to nerve stimulator guidance in patients undergoing upper limb surgeries?
RCT (n=50)
Open-label
Computer assisted randomization
No
Does ultrasound-guided supraclavicular brachial plexus block improve block success and reduce execution time compared to nerve stimulator guidance in patients undergoing upper limb surgeries?
Absolute Event Rate: 4.12% vs 7.98%
p-value: p=<0.05
Ultrasound-guided supraclavicular brachial plexus block is superior to nerve stimulator guidance, offering faster execution, quicker onset, and higher success rates for upper limb surgeries.
Small RCT in Indian patients suggests USG may enhance supraclavicular block performance; leaves open need for larger multicenter confirmation.
Background: Peripheral nerve blocks can be performed by several methods. The present study was undertaken to compare peripheral nerve stimulator and US guided supraclavicular block for upper limb orthopedic surgeries in Indian population. Method: A total 50 patients undergoing upper limb surgeries were enrolled in the study and randomly divided into two groups of 25 patients in each group. Group PNS (Nerve stimulator guided) and Group USG (USG guided) supraclavicular brachial plexus block. Results: The mean time for block execution in group USG was less (4.12±1.53) compared to group PNS (7.98±1.78), (P0.05). Majority of patients among Group USG had bradycardia (16%) than group PNS (8%). Most of the patients among Group USG had good success rate (96%) compared to group PNS (76%) with statistically significant difference, (p<0.05). Conclusion: The supra clavicular brachial plexus block using ultrasound guided method is an improved nerve block technique due to visualization of nerves with more success, decreased complication rate, and less time consuming, smaller volume of local anaesthetic agent required, as compared to nerve stimulator.
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Chaturvedi et al. (2024) conducted an RCT in Upper limb orthopedic surgeries (n=50). Ultrasound-guided supraclavicular brachial plexus block vs. Nerve stimulator-guided supraclavicular brachial plexus block was evaluated on Mean time for block execution (minutes) (p=<0.05). Ultrasound-guided supraclavicular brachial plexus block significantly reduced mean block execution time (4.12 vs 7.98 minutes) and increased the success rate (96% vs 76%) compared to nerve stimulator guidance.
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