Usefulness of ultrasound-guided infraclavicular brachial plexus block: a comparison with nerve stimulation method

Background: Recently, ultrasound guidance in clinical procedures including brachial plexus block has gained popularity.This method has been considered to be an efficient and a useful method with real-time visualization.Many reports have showed the usefulness of ultrasound-guided brachial plexus block.We evaluated the usefulness of ultrasound guidance in infraclavicular brachial plexus block compared with nerve stimulation.Methods: Thirty patients were randomized into two groups of US group (ultrasound-guided block) and NS group (nerve stimulation).Blocks were performed with mepivacaine 2% and bupivacaine 0.5% with epinephrine 1：200,000 (total volume 40 ml).Block execution time, onset time, success rate, patient's discomfort and complications were measured and statistically evaluated for the comparison.Results: Block execution time were 88.3 ± 48.1 sec in US group and 172.7 ± 103.1 sec in group NS, respectively (P = 0.017).Onset time were 16.0 ± 6.9 min and 17.7 ± 7.8 min (P = 0.434).Success rates were 93.3% and 80.0% (P = 0.283).Patient's discomfort was not significantly different.Pain in patients with fractured arm was significantly lower in US group (P = 0.004).Conclusions: An ultrasound-guided infraclavicular brachial plexus block is useful with less time consumption and less discomfort in patients with fracture of arm.Success rate and onset time were acceptable.(Korean J Anesthesiol 2008; 55: 436∼40)