A COMPARATIVE STUDY BETWEEN TWO DIFFERENT CURRENT STRENGTHS FOR SUPRACLAVICULAR BLOCK USING NERVE STIMULATOR IN ELECTIVE UPPER LIMB SURGERIES BELOW ELBOW

M. Kalasree; M. Ravikumar; G.Kanchana

Volume : VII, Issue : X, October - 2017

A COMPARATIVE STUDY BETWEEN TWO DIFFERENT CURRENT STRENGTHS FOR SUPRACLAVICULAR BLOCK USING NERVE STIMULATOR IN ELECTIVE UPPER LIMB SURGERIES BELOW ELBOW

M. Kalasree, M. Ravikumar, G. Kanchana

Abstract :

BACKGROUND

Brachial plexus blockade provides excellent analgesia and anaesthesia for upper limb surgeries with reduced hospital stay and cost when compared with general anaesthesia. This study is designed to make nerve stimulator guided technique better by compå the quality of blockade when performed at two different current strengths of 0.5 and 0.9 mA.

AIM

To study the quality of blockade while using two different current strengths for supraclavicular block with nerve stimulator in elective upper limb surgeries below elbow.

MATERIALS AND METHODS

After obtaining Institutional Ethical Committee approval, 60 patients of ASA I or II aged 16 to 60 years undergoing elective upper limb surgeries below elbow were selected and randomly divided into two groups. With informed consent, all patients received supraclavicular block by Winnie’s approach with 15 ml of 2% Lignocaine with 1:2,00,000 adrenaline plus 15 ml of 0.5% bupivacaine. The nerve stimulator was initially set to deliver a current of 0.9 mA. After obtaining twitch of hand or fingers in flexion or extension, drug was injected in group B and current strength was gradually reduced till response was similarly obtained with 0.5 mA and the drug was injected in group A. A blinded observer recorded the duration of surgery, time of onset of sensory and motor blockade, total duration of sensory and motor blockade, time taken for rescue analgesia and complications.

STATISTICAL ANALYSIS

The data were analyzed using the SPSS (version 16) software. The parametric and non parametric data were analyzed with Student’s ‘t’ test and Chi–square test. A p value < 0.05 was considered statistically significant.

RESULTS

There was no statistically significant difference in both groups with respect to time taken to perform the block, onset of sensory and motor blockade and duration of motor and sensory blockade. There were no complications in both the groups.

CONCLUSION

We conclude that nerve stimulator guided blocks may be performed at the initial seeking current itself (< 1 mA) to avoid multiple attempts and unnecessary needle manipulations which may prove harmful to the patient.