Abstract

MODIFIED CERVICAL APPROACH FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Author(s): Rouf Bashir, Imran Sheikh

BACKGROUND
There have been several studies on cervical approach for supraclavicular brachial plexus block. It is given in the apical area between the medial and lateral heads of sternocleidomastoid muscle. The technique has lesser complications and higher success rate. I modified the technique slightly, by approaching through the apical area but 0.5 – 1 cm below the apex at the medial border of lateral head of sternocleidomastoid muscle, at the level of cricoid cartilage.
MATERIALS AND METHODS
The study was conducted at SKIMS Medical Collage Hospital, from July 2014 to July 2017. It was a prospective non-randomized open level study. Three hundred patients of both sexes, aged between 18 and 65 years with ASA grade I and II scheduled to undergo elective major surgery of the upper limb from proximal arm to the hand varying from patient to patient, were selected.
RESULTS
The onset, duration of sensory and motor block, any complications, and need for supplement anaesthesia were observed. Success and complication rates were calculated in percentage. Average onset and duration of sensory and motor block was calculated as mean ± SD and percentage. Out of 300 patients, 260 (86.8%) got successful block with no significant complications.
CONCLUSION
In our study we conclude that performing supraclavicular block of brachial plexus using modified cervical approach is technically more feasible, gives better quality block, has very less chances of complications like pneumothorax and extent and density of block can be better managed. We observed better patient satisfaction.