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Brachial plexus block as a sole anaesthetic technique in upper extremity fracture/dislocation in children: subclavian

B K Bhattarai1, P R Baral

  • 1Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal. bhattaraibk@yahoo.com

Kathmandu University Medical Journal (KUMJ)
|July 8, 2008
PubMed

Insights

The parascalene approach for brachial plexus block is as safe and effective as the classical subclavian perivascular approach for pediatric elbow fracture manipulation. Both techniques show high success rates and acceptance among patients, parents, and surgeons.

Area of Science:

  • Anesthesiology
  • Pediatric Orthopedics

Background:

  • Brachial plexus blocks are crucial for pediatric orthopedic procedures.
  • Comparing different anesthetic techniques ensures optimal patient outcomes and safety.

Purpose of the Study:

  • To compare the parascalene approach with the classical subclavian perivascular approach for brachial plexus blocks.
  • To evaluate these techniques as sole anesthetic methods for children undergoing elbow fracture manipulation.

Main Methods:

  • Sixty children (6-13 years) with elbow fractures were randomized into two groups.
  • Group I received the classical subclavian perivascular approach; Group II received the parascalene approach.
  • Key metrics included block performance time, onset of analgesia, sensory block, relaxation, complications, and acceptance.

Main Results:

  • The classical subclavian perivascular approach showed significantly shorter times for block performance, analgesia onset, and sensory block onset.
  • Both techniques demonstrated high acceptance and success rates.
  • Minor complications were observed, with a notable incidence of Horner's syndrome in the parascalene group.

Conclusions:

  • The parascalene approach is comparable to the classical subclavian perivascular approach in safety, success, and acceptance for pediatric elbow fracture management.
  • Both brachial plexus block techniques are suitable for sole anesthetic use in this patient population.
Abstract

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