Clinical Efficacy of Ultrasound Guidance in Brachial Plexus Nerve Conduction Study: A Comparative Analysis

Brachial plexopathy is a diagnostically challenging condition that requires a comprehensive evaluation, including physical examination, imaging, and Electrodiagnostic (EDx).

Ultrasound guidance may improve the efficiency and precision of nerve conduction studies by addressing the limitations of blind techniques, such as discomfort and inaccurate localization.

We prospectively enrolled 30 patients undergoing electrodiagnostic testing. The left upper limb was examined with ultrasound guidance (Group A), while the right upper limb underwent the blind method (Group B). The examined nerves included the median, ulnar, radial, medial and lateral antebrachial cutaneous, axillary, musculocutaneous, suprascapular, and long thoracic nerves. Stimulation duration, number of stimulation attempts, average current, and total examination time were recorded. The differences in data between the two groups were compared and analyzed.

Group A demonstrated significantly lower stimulation duration (156.70±50.13 vs. 260.17±53.19 s), fewer stimulation attempts (17.73±3.94 vs. 25.80±5.23), and lower average current [32.45 (30.28, 40.13) vs. 42.75 (37.78,50.68) mA] compared to Group B (all P < 0.001). No significant difference was observed in total examination time (387.40 ± 33.72 vs. 372.00 ± 47.01 s; P = 0.150).

Ultrasound guidance improves procedural precision and reduces the need for repeated stimulations and higher electrical intensities. These benefits are achieved without extending the total examination time, making it a feasible and patient-friendly approach for routine use in clinical neurophysiology.

Ultrasound-guided nerve conduction studies of the brachial plexus enhance procedural efficiency and patient comfort compared to the blind method. Further large-scale studies are recommended to validate these findings and assess broader clinical applications.