A Comparative Study of Interscalene and Supraclavicular Approach of Brachial Plexus Block on Upper Limb Surgeries

Introduction: There are different methods to perform brachial plexus block. Interscalene and supraclavicular approaches are the most frequently used technique during upper limb surgeries.The aims of this study were to compare the onset and duration of sensory and motor block, hemodynamic parameters, sparing of analgesia in any dermatome and to observe any adverse effect during lower arm, elbow and forearm surgeries. Materials and methods: After approval from the ethics committee and written informed consent, 70 patients were randomly allocated into two equal groups. Interscalene and supraclavicular block were administered with 30 ml of levobupivacaine in group ISB and group SCB patients respectively using the nerve stimulator for lower arm, elbow and forearm surgeries. The onset and duration of sensory block, hemodynamic parameters and any adverse effect were noted. Results: The demographic data, duration of surgery, baseline and intraoperative heart rate, mean arterial pressure and oxygen saturation were comparable in both groups. The onset of sensory and motor block was earlier in the supraclavicular group than the interscalene group but there was no sparing of any dermatome in the interscalene group. The duration of sensory block was significantly prolonged in the supraclavicular group but there was no difference regarding the duration of motor block among the two groups. Incidence of vessel puncture and Horner’s syndrome were more in supraclavicular and interscalene group respectively. Conclusion: Interscalene block was equally effective like supraclavicular block for lower arm, elbow and forearm surgery with minimum complications.