Research Article
Sayali Bonde and Girish Saunda
Abstract
Background and Objectives: Landmark technique has been traditionally used for performing the supraclavicular block, popularly known as the “spinal of the upper limb”. This technique is associated with numerous complications and increased failure rates. Ultrasound guidance was introduced as a remedy to the ill effects of the conventional landmark technique. However, a need was appreciated to comprehensively evaluate the safety and usefulness of ultrasound over landmark based technique. Hence a study was planned comparing various characteristics of both blocks. Our principle objective was to ascertain qualitatively and quantitatively the benefit of ultrasound guidance for supraclavicular blocks. Materials and Methods: A prospective double blinded randomized study was carried out which included 100 adult patients between the ages of 18 and 60 years (of ASA I/II grade) who underwent upper limb orthopedic surgeries. Patients were randomly allocated into two groups; Group C: patients receiving supraclavicular block by conventional technique and Group USG: using ultrasound technique, comprising of 50 patients each. Parameters compared included - time taken for the procedure, onset of sensory blockade, onset of motor blockade, duration of analgesia, quality of operative conditions, incidence of complications such as vessel puncture, pneumothorax, nerve injuries and incidence of incomplete and failed blocks. Results: We concluded that compared with conventional technique for supraclavicular block, ultrasound technique provides- (1) Faster onset of sensory block (2) Faster onset of motor block (3) Increased duration of analgesia (4) Better quality of operative conditions (5) Decreased incidence of incomplete blocks/block failure (6) Decreased incidence of complications Also, the average block execution time was found to be shorter in USG group than the C group (p value<0.001). The difference was statistically highly significant. Conclusion: Ultrasound guided block not only provides superior block characteristics but also greatly reduces patient discomfort. Thus, the use of ultrasound proves to be more beneficial and is advocated.