Comparison between Supraclavicular and Infraclavicular Brachial Plexus Block in Patients Undergoing Forearm Surgeries.

Of the various modalities of achieving surgical anaesthesia of the forearm, brachialplexus block by injecting local anaesthetic is considered highly beneficial andpractical. Supraclavicular and infra-clavicular approaches of brachial plexus blocksprovide comprehensive anaesthesia for surgeries of the forearm. The primaryoutcome measured was the comparison of two blocks with respect to sparing of anydermatome, whereas the secondary outcomes measured were block performancetime, duration of analgesia, and complications associated with each technique.METHODSSixty adult patients of either sex belonging to the American Society ofAnesthesiologists (ASA) physical status I and II in the age range of 20–70 yearsscheduled to undergo surgeries of the forearm were divided into two groups:Supraclavicular (SCB group) and Infraclavicular (ICB group) of 30 each. Both theblocks were given by 30 mL of 0.375% injection Bupivacaine using a 22G, 5 cminsulated needle and nerve locator. Both the groups were compared with respect tosparing of dermatomes, block performance time, duration of analgesia andcomplications like Horner’s syndrome, vascular puncture, and pneumothorax.Statistical analysis was performed with Student unpaired t‑test and Chi‑square testand p < 0.05 was considered to be statistically significant.RESULTSBlock performance time was similar in both the groups. Duration of analgesia wascomparable among the two groups. The incidence of incomplete radial block wassignificantly higher in ICB group as compared to SCB group (p= 0.046, S). Incidenceof Horner’s syndrome in SCB group were higher than in ICB group, but they werestatistically insignificant. (p=0.15, NS). One patient in SCB group had subclavian veinpuncture as compared to none in ICB group and was statistically insignificant.CONCLUSIONSSupraclavicular approach for brachial plexus block provides reliable andcomprehensive anaesthesia for forearm surgeries without any significantdermatomal sparing unlike infraclavicular approach. Both groups had similar blockperformance time and duration of analgesia for forearm surgeries. Even though SCBwas associated with complications like Horner’s syndrome and vascular puncture, itwas transient and statistically insignificant. Hence supraclavicular approach isconsidered to be superior to infraclavicular approach.

A Comparative Prospective Randomized Clinical Study Between Supraclavicular Perivascular Technique And Infraclavicular Brachial Plexus Blockade For Below Elbow Surgeries

OBJECTIVE: To compare the efficacy of supraclavicular perivascular technique and vertical infraclavicular achial plexus block, using nerve locator for below elbow surgeries. MATERIALS AND METHODS: Eighty patients of ASA grade I or II of either sex undergoing below elbow surgeries (mostly orthopedic surgeries) were randomly allocated into group S and group I. Each group comprises of 40 patients. Surgery was done under Vertical Infraclavicular approach of Brachial plexus Block in Group I Supraclavicular perivascular approach of Brachial plexus block in GroupS. RESULTS: The supraclavicular perivascular technique and vertical infraclavicular achial plexus block, using nerve locator for below elbow surgeries to evaluate the Ease of technique ,Time taken for the onset of sensory and motor blockade ,Total duration of sensory and motor blockade and Occurrence of complications statistically showed no significant differences between the two groups. CONCLUSION: Nerve locator guided Infraclavicular block of achial plexus is similar to nerve locator guided supraclavicular block in the form of ease of technique, onset and duration of sensory & motor blockade and on complication rate.

Orthogonal design the knee peripheral nerve radiofrequency ablation treatment of knee osteoarthritis / 重庆医学

Objective Explore a new treatment by orthogonal design of no empty cases :treatment of knee osteoarthritis by nerve locator ,for knee joint peripheral nerve branch implement selective radio frequency ablation .Methods According to patients′age ,body mass index ,gender ,organs ,in the course of the disease ,preoperative VAS score ,first divided into nine groups ,each group of four people ,then randomly assigned to four groups and each group 9 cases ,a total of 36 people .With nerve locator ,design of 4 factors and 3 levels ,no empty cases of orthogonal design ,every time 9 people by radio frequency ablation treatment of knee joint pe-ripheral nerve .Repeat 4 times to reduce the sampling error ,obtain the VAS difference between postoperative 1 week and preopera-tive .Results The best combination of treat knee joint osteoarthritis by Radio frequency ablation was A3B3C(1-3)D(1-3) .Selective radio frequency ablation knee peripheral nerve branch target rf temperature is 90 ℃ ,120 seconds ,lidocaine concentration(0 .5% to 2% ) and lidocaine measurement (0 .5 to 1 .5 mL) .Conclusion Using the orthogonal design of no empty cases ,for knee joint pe-ripheral nerve branch for selective radio frequency ablation by nerve locator .Treatment of knee joint osteoarthritis in A3B3C(1-3) D (1-3) combination effect exact ,minimally invasive ,safe ,accurate location ,the treatment effect is good ,low cost ,simple and high ef-ficiency .