Comparison of USG-Guided Supraclavicular Brachial Plexus Block by Single-Point Versus Multiple-Point Injection...

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Ultrasound-Guided Procedures

Background:

• Supraclavicular block is a common regional anesthesia technique for upper limb surgeries.
• Optimizing block success and minimizing nerve injury are key clinical goals.
• Ultrasonography guidance enhances precision in regional anesthesia.

Purpose of the Study:

• To compare the success rate of single-point versus multiple-point injection techniques for ultrasonography-guided supraclavicular block.
• To evaluate nerve sparing, procedural time, and onset of sensory and motor block between the two techniques.

Main Methods:

• 204 patients undergoing upper limb surgery received ultrasonography-guided supraclavicular block with 0.5% Ropivacaine.
• Patients were randomized into single-point (Group A) and multiple-point (Group B) injection groups using an out-of-plane technique.
• Nerve efficacy, procedural time, and block onset were assessed.

Main Results:

• The success rate was significantly higher in the multiple-point group (98%) compared to the single-point group (60.8%).
• Nerve sparing was notably less in the multiple-point group, with the intercostobrachial nerve being most frequently spared.
• Onset of sensory and motor block was similar between groups, though procedural time was longer in the multiple-point group.

Conclusions:

• Multiple-point injection technique for ultrasonography-guided supraclavicular block offers a higher success rate.
• The single-point injection technique appears to offer better nerve sparing.
• Careful technique and patient selection are crucial for optimizing outcomes in supraclavicular blocks.