[Brachial plexus anesthesia: results of a modified perivascular supraclavicular technique]

To compare a modified supraclavicular perivascular approach with the axillary perivascular technique for providing brachial plexus blockade.

We studied 100 ASA I/II patients undergoing surgery on upper extremities. Patients were divided into two groups: group 1 (axillary, n = 50) and group 2 (modified supraclavicular, n = 50 ). Patients needing shoulder surgery were excluded from group 1. In both groups 35 ml of 1.5% mepivacaine plus 0.05 mEq/ml of bicarbonate was used. The Winnie axillary perivascular technique was used in group 1. In group 2 we used a modification of the lateral perivascular supraclavicular technique described by Brown, with the needle directed cephalad, medial and posterior to provide paresis in the upper extremity. We recorded the degree of difficulty and time needed for each technique, time until start of paresis and time of motor paralysis in the extremity, area of nerve deficit, and quality of block. In group 2 we measured the depth of paresthesia. Perioperative complications were noted for each group.

There were no significant differences in difficulty, time or quality of block. Time until start of paresis and time of motor paralysis were significantly shorter in group 2 (12.0 +/- 2.5 versus 4.9 +/- 0.2 min, and 15.2 +/- 6.9 min versus 35.3 +/- 5.2, in groups 2 and 1, respectively). Mean depth of paresthesia was 44.1 +/- 5.2 min. The most frequently recorded complications were Horner's syndrome in group 2 and vascular puncture in group 1.

The modified perivascular lateral supraclavicular technique is a safe, effective method for providing brachial plexus block.