Effects of different approaches of infraclavicular brachial plexus block on perfusion index and tissue perfusion

Although both the lateral sagittal and costoclavicular approaches are applied at the cord level in the infraclavicular region, there is a major difference between the distributions of the two approaches. We aimed to investigate the effects of this different distribution on tissue perfusion and oxygenation.

Sixty patients undergoing elective elbow, forearm, wrist and hand surgery under infraclavicular brachial plexus block were included in the study. Patients were divided into two groups: group CC (costoclavicular approach, n = 30) and group LS (lateral sagittal approach, n = 30). The primary outcomes of this study were increased perfusion index (PI) and tissue oxygen saturation (StO₂) rate. Secondary outcomes were the duration of block application, sensory and motor block onset time, time to first analgesic need and duration of motor block.

The PI and StO₂ increased significantly from baseline to each time point in both groups; however, there were no significant differences between the groups. The time to reach the sensory block stage was shorter with the costoclavicular approach. The duration of block application was shorter when using the costoclavicular approach. There were no differences between the approaches in terms of the time to the first analgesic requirement or need for additional analgesics.

The different distributions of the two different approaches to infraclavicular brachial plexus block, costoclavicular and lateral sagittal, did not have an additional effect on tissue perfusion and oxygenation. Both approaches can be preferred especially in surgeries in which an increase in tissue perfusion is desired owing to perfusion-enhancing properties.

NCT04764591.