A comparison of two approaches to brachial plexus anaesthesia

Background: A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulation technique for upper limb surgery. Methods: Eighty patients undergoing upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled into this study. The infraclavicular brachial plexus block was performed using the vertical technique (group I; N=40). The supraclavicular brachial plexus block was performed using the Kulenkampf technique (group S; N=40). In both the groups 30 ml of 0.5% ropivacaine was used as the local anaesthetic. The block performance time, the duration of onset of sensory and motor block was evaluated in both the groups S & I. The quality of the block & associated complications were also assessed. Results: A significant difference in the block performance time with comparable duration of onset of sensory was noted between the two groups S & I. Greater incidence of Horner’s syndrome was noted in group S. Conclusions: Supraclavicular brachial plexus block may be easier to perform than infraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications.