scholarly journals A comparative study to evaluate the efficacy of ultrasound guided brachial plexus block and peripheral nerve block for upper limb surgeries

2019 ◽  
Vol 6 (2) ◽  
pp. 248-253
Author(s):  
Vikas S Joshi ◽  
Mohammed Mukarram Iqbal ◽  
Kaja Sriram Murthy
2018 ◽  
Vol 5 (5) ◽  
pp. 1304
Author(s):  
Roopal R. Garaniya ◽  
Sheetal Shah ◽  
Noopur Prajapati

Background: Brachial plexus block via interscalene approach is an excellent option for upper limb surgeries, but due to sparing of ulnar nerve (lower trunk, C8-T1) and its’ complications, it is not so popular. To overcome this problem, interscalene block via lower approach has been tried which has more advantage in view of ulnar nerve blockage and also less complications. In addition, ultrasound provides reliability, ease, rapidity and also patient comfort during block procedure. This prospective study was performed to evaluate the anaesthetic effect of lower approach interscalene block with the help of ultrasound and peripheral nerve stimulator.Methods: Ultrasound guided interscalene brachial plexus block via lower approach was given in randomly selected 30 patients, undergoing upper limb orthopaedic surgeries. After localisation of brachial plexus with ultrasound, the nerve roots were confirmed with the help of peripheral nerve stimulator, before injecting drug. At 5 and 15 min after block, all patients were assessed for the effect. Postoperatively they were assessed for any complication and also for their satisfaction level by Likert’s scale.Results: In territories of ulnar, radial and musculocutaneous nerve there was 100% effect while in median nerve territory 92.8% motor block was there. There was no need of analgesics during intra operative period in any patient and there were no major complications with this approach.Conclusions: Ultrasound guided interscalene block via lower approach is an excellent alternative for upper limb surgeries over classical approach in view of ulnar nerve blockage without any major complication.


Author(s):  
Fahad Khan ◽  
V. P. Singh

Background: Comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries.Methods: Patients in the age group 18-58 years both male and female, having ASA 1 and ASA 2, scheduled for elective surgery of unilateral upper limb surgeries were included and randomly divided into three groups’ i.e. group RD, group RDI and group R and patients with chronic pain or taking any analgesics, ASA grade III and IV, bleeding disorders, history of brachial plexus injury, known allergy to the study drug, previous shoulder surgery, any psychiatric disorders, peripheral neuropathy, failed block, significant respiratory disease, hearing impairment, pregnant women, study were excluded.Results: Time to sensory onset in group RD was as compared to group RDI and group R was found statistically significant (p<0.001). Duration of sensory block (analgesia) in group RD, group RDI and Group R was also statistically significant (p<0.001). The level of sedation of Group RDI and Group RD had highly significant value till 30 mins (p<0.001).Conclusions: The central effects of dexmedetomidine also play some role in prolongation of sensory and motor block duration, as explained previously.


2021 ◽  
pp. 18-20
Author(s):  
Noyomi Saring ◽  
Tabu Muri ◽  
Tomar Basar

Background: In modern practice of Anaesthesia, Regional Anesthesia by peripheral nerve block is one of the most common methods to achieve Anaesthesia alone or in conjunction with general anaesthesia. It is a successful method, as famously quoted by Denny M and Harrop-Grifths in their study, “Regional anaesthesia always works —provided you put the right dose of the right drug in the right place”. We aim to determine effective volume of local anaesthetic using 0.5% Bupivacaine and 2% Lignocaine with Adrenaline 1: 200000 in equal proportion by ultrasound guided Supraclavicular Brachial Plexus Block (SBPB). Methods: This study was conducted in Department of Anaesthesiology, Tomo Riba Institute of Health and Medical Sciences (TRIHMS), Naharlagun, Arunachal Pradesh. 52 patients of age 18 – 60years of age, both male and female who had undergone Orthopaedic surgeries of arm and forearm were included in this study. We aim to nd out the Effective volume of Local Anaesthetics used to achieve Ultrasound guided Supraclavicular Brachial Plexus Block by injecting 0.5% Bupivacaine with 2% Lignocaine with Adrenaline 1:200000 using in plane (lateral to medial) approach. Result: We found success rate of 92.3% in our study. The mean effective volume of local anaesthetic was 15ml (SD = ±4.711). From our study, we conclude that peripheral nerve block by Ultrasound guided SBPB can be achieved with low volume of local anaesthetics and thereby increasing the safety of the procedure. Statistical analysis was done using SPSS 27.


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