A Comparative Evaluation of Techniques in Interscalene Brachial Plexus Block: Conventional blind, Nerve Stimulator Guided and Ultrasound Guided.

ABSTRACT

Background: This study was conducted to compare the three technique Conventional blind, Nerve stimulator guided and Ultrasound guided for Interscalene brachial plexus block in surgeries of upper limb. Methods: Total 60 patients were included in our study which were randomly allotted by closed envelope technique into either of the three groups namely Conventional blind (group CB), US-guided (group US) or NS-guided (group NS). The drug bupivacaine 0.5% (2 mg/kg) was used and diluted with normal saline to make a total volume of 30 ml. Results: Comparison between the Conventional blind (CB), Nerve Stimulator (NS) and Ultrasound guided (US) technique of interscalene brachial plexus block revealed that the block execution time, time of onset of sensory and motor block was significantly less in ultrasound group as compare to other groups. The mean duration of analgesia too, was significantly higher in both NS and US group (3 hr & 23 min ,3 hrs 30 min respectively), while it was 2 hr 47 min in CB group. The incidence of patchy effect (3 cases) and blockade failure requiring general anesthesia (4 cases) were significantly higher in CB group compared to NS group (2 cases each) and US group (1 case each). Conclusion: The success rate and effective quality of the block were more satisfactory with ultrasound technique than the nerve stimulator or conventional blind technique.