scholarly journals Pulse Oximeter Perfusion Index as a Predictor of Successful Supraclavicular Brachial Plexus Block

2021 â—½  
Author(s):  
Karthik S. L. â—½  
Vishwanath Ankad â—½  
Keyword(s):  
Brachial Plexus â—½  
Upper Limb â—½  
Brachial Plexus Block â—½  
Prospective Trial â—½  
Perfusion Index â—½  
Ultrasound Guided â—½  
Study Objective â—½  
Supraclavicular Brachial Plexus Block â—½  
Supraclavicular Block â—½  
Plexus Block

Abstract Objective Ultrasound-guided supraclavicular brachial plexus block is a popular anesthetic technique for upper limb surgeries. Assessing the success sensory and motor block using conventional methods is time consuming and also it needs patient co-operation. In the present study, objective method like increase in perfusion index is used to predict the success of ultrasound-guided supraclavicular block. Materials and Methods  This prospective trial consists of total 95 patients undergoing elective upper limb procedures. All patients received ultrasound-guided supraclavicular block using 0.5% bupivacaine 20 mL. Sensory and motor blocks were evaluated every 5 minutes followed by pinprick testing and ability to flex the elbow and the hand against gravity, respectively. The perfusion index was measured using pulse oximetry applied on the index finger and recorded at baseline and 10, 20, and 30 minutes interval after local anesthetic injection in both the blocked limb and the contralateral unblocked limb using two separate pulse oximeters. Results Perfusion index increased in blocked arm after 5 minutes compared with unblocked arm and also to its baseline value. Both perfusion index and perfusion index ratio in blocked arm were found statistically significant. Conclusion To evaluate the success of supraclavicular block, perfusion index can be considered as a useful tool.

A comparative study between Bupivacaine volumes on diaphragmatic mobility in Ultrasound guided Supraclavicular Block

QJM â—½  
2021 â—½  
Vol 114 (Supplement_1) â—½  
Author(s):  
Israa Tarek Mohamed Abdelaziz â—½  
Ahmed Nagah El shaer â—½  
Tamer Yousef Elie â—½  
Wael Abd Elaziz Mohamed
Keyword(s):  
Brachial Plexus â—½  
Upper Limb â—½  
Brachial Plexus Block â—½  
Intravascular Injection â—½  
Ultrasound Guided â—½  
Supraclavicular Brachial Plexus Block â—½  
Group A â—½  
Group B â—½  
Supraclavicular Block â—½  
Plexus Block

Abstract Background Brachial plexus is a complex network of nerves supplying the whole upper limb, with both motor and sensory supply. It arises from the neck and passes through the axilla to the upper limb. It is composed of 5 roots, 3 trunks, 6 divisions, 3 cords, and terminal branches. Objective To compare the effect of two different volumes of bupivacaine (20 ml and 25 ml) on diaphragmatic mobility within 15 and 30 minutes from ultrasound guided supraclavicular brachial plexus block in upper limb orthopedic surgeries. Patients and Methods In our study, 40 patients were randomly divided into 2 equal groups. Group A received 20 ml of bupivacaine (0.5%) and group B in which patients received 25 ml of bupivacaibe (0.5%). Diaphragmatic excursion measured in both groups after 15 and 30 mins sequentially. Results Our study showed that the use of low volume of bupivacine has much lower incidence of phrenic nerve affection, and in turn affection of mobility of the diaphragm measured by diaphragmatic excursion. Conclusion Assessment of diaphragmatic excursion is the best indication of phernic nerve injury after supraclavicular block. The use of the ultrasonography is the fastes, easiest and safest method for this assessment. The use of ultrasonography in performing the supraclavicular nerve block decreased significantly the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.

scholarly journals Comparison of effects of dexmedetomidine and clonidine as adjuvant to bupivacaine 0.25% in ultrasound guided supraclavicular brachial plexus block

2017 â—½  
Vol 5 (10) â—½  
pp. 4512 â—½  
Author(s):  
Usha K. Chaudhary â—½  
Amruth Danesh â—½  
Monika Mahajan â—½  
Sudarshan Kumar â—½  
Versha Verma â—½  
...  
Keyword(s):  
Brachial Plexus â—½  
Upper Limb â—½  
Brachial Plexus Block â—½  
Categorical Variables â—½  
Control Group â—½  
Double Blind Study â—½  
Continuous Variables â—½  
Ultrasound Guided â—½  
Supraclavicular Brachial Plexus Block â—½  
Plexus Block

Background: Ultrasound guided brachial plexus block is the preferred technique for surgeries on upper limb. Adjuvants are usually added to peripheral nerve blocks to increase their analgesic efficiency and duration. We compared analgesic effects of dexmedetomidine 1mcg/kg and clonidine 1mcg/kg as adjuvant to a low volume of bupivacaine in USG guided supraclavicular brachial plexus block.Methods: A prospective, randomized controlled, double blind study planned after permission from institutional ethics committee. Sixty ASA grade I, II patients, 18-60 years undergoing upper limb orthopedic surgery included. Group 1 (Control group) received 20 ml of 0.25% bupivacaine. Group 2 (Dexmedetomidine group) received 20ml of bupivacaine + dexmedetomidine (10 ml of 0.5% bupivacaine + 1µg/kg of dexmedetomidine, diluted with 0.9% NS to 20 ml) Group 3 (Clonidine group) received 20 ml of 0.25 bupivacaine + clonidine (10ml of 0.5% bupivacaine+1µ g/kg of clonidine, diluted with 0.9% NS to 20 ml) in USG guided supraclavicular brachial plexus block. Continuous variables analyzed with analysis of variance or Kruskal-Wallis test and categorical variables with Fisher’s exact test.Results: Pain free period was 864.90±357.16 minutes: dexmedetomidine group; 584.59±172.38 minutes: clonidine group, 431.78±138.40 minutes: control group with p< 0.001. VRS (verbal rating score) was significantly higher in control group as compared to dexmedetomidine at 4 hours but the pain scores were comparable between all the groups after 8 hours of block.Conclusions: Dexmedetomidine as an adjuvant to bupivacaine provides prolonged anaesthesia, better pain relief in early postoperative period with haemodynamically stable, calm patients compared to clonidine and control group.

scholarly journals A comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries

2018 â—½  
Vol 6 (7) â—½  
pp. 2407
Author(s):  
Fahad Khan â—½  
V. P. Singh
Keyword(s):  
Comparative Study â—½  
Brachial Plexus â—½  
Upper Limb â—½  
Brachial Plexus Block â—½  
Elective Surgery â—½  
Study Drug â—½  
Sensory Block â—½  
Ultrasound Guided â—½  
Supraclavicular Brachial Plexus Block â—½  
Plexus Block

Background: Comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries.Methods: Patients in the age group 18-58 years both male and female, having ASA 1 and ASA 2, scheduled for elective surgery of unilateral upper limb surgeries were included and randomly divided into three groups’ i.e. group RD, group RDI and group R and patients with chronic pain or taking any analgesics, ASA grade III and IV, bleeding disorders, history of brachial plexus injury, known allergy to the study drug, previous shoulder surgery, any psychiatric disorders, peripheral neuropathy, failed block, significant respiratory disease, hearing impairment, pregnant women, study were excluded.Results: Time to sensory onset in group RD was as compared to group RDI and group R was found statistically significant (p<0.001). Duration of sensory block (analgesia) in group RD, group RDI and Group R was also statistically significant (p<0.001). The level of sedation of Group RDI and Group RD had highly significant value till 30 mins (p<0.001).Conclusions: The central effects of dexmedetomidine also play some role in prolongation of sensory and motor block duration, as explained previously.

scholarly journals Comparison between conventional and ultrasound-guided supraclavicular brachial plexus block in upper limb surgeries

2017 â—½  
Vol 11 (2) â—½  
pp. 467 â—½  
Author(s):  
KiranAbhayakumar Honnannavar â—½  
MahanteshShivangouda Mudakanagoudar
Keyword(s):  
Brachial Plexus â—½  
Upper Limb â—½  
Brachial Plexus Block â—½  
Ultrasound Guided â—½  
Supraclavicular Brachial Plexus Block â—½  
Plexus Block

scholarly journals Hoarseness of Voice following Left Supraclavicular Brachial Plexus Block: A Case Report

10.31729/jnma.7087 â—½  
2021 â—½  
Vol 59 (241) â—½  
pp. 925-928
Author(s):  
Subin Shrestha â—½  
Sadikshya Regmi â—½  
Gopendra Deo â—½  
Indra Narayan Shrestha
Keyword(s):  
Brachial Plexus â—½  
Recurrent Laryngeal Nerve â—½  
Brachial Plexus Block â—½  
Rare Complication â—½  
Local Anaesthetics â—½  
Laryngeal Nerve â—½  
Ultrasound Guided â—½  
Supraclavicular Brachial Plexus Block â—½  
Supraclavicular Block â—½  
Plexus Block

Supraclavicular brachial plexus block is extensively used for primary regional anaesthesia as well as postoperative analgesia for the surgical procedures of the upper limb. The evidence for the use of ultrasound in supraclavicular brachial plexus is growing day by day as it has the advantage of allowing real time visualisation of the plexus, pleura and vessels along with the needle and local anaesthetics spread. Despite this, complications can even arise with ultrasound guided supraclavicular brachial plexus block. Hoarseness of voice due to recurrent laryngeal nerve block is a rare complication of supraclavicular brachial plexus block. There are few reported cases of hoarseness of voice following the right supraclavicular block. There is only one reported case of hoarseness of voice following the left supraclavicular block. Here, we report a case of a 16-year-old boy who developed hoarseness of voice due to left recurrent laryngeal nerve following ultrasound guided left supraclavicular brachialplexus block.

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