Abstract
This prospective randomized trial was conducted to compare the quality and outcome of perioperative anesthesia between axillary brachial plexus block combined with axillary nerve block (axillary approach group,AX) and supraclavicular brachial plexus block( supraclavicular block group, SU). The primary outcome measure was to compare anesthesia quality evaluation including sensory function, motor function, and subjective feeling scores during skin incision, 30 minutes after skin incision, and at the end of surgery, and postoperative analgesia maintenance time score. Secondary outcomes included the number of patients in whom sufentanil was used, dexmedetomidine (Dex) dose, duration of sensory and motor blocks, number of patients who required remedial analgesia, and procedural complications.The proportion of patients in whom good-to-excellent anesthesia quality was achieved in AX group and SU group were 80% and 76.7%, respectively; anesthesia failure did not occur in both groups. Both procedures met the needs of surgical anesthesia and analgesia. Anesthesia quality and incidence of sufentanil use did not significantly differ between the groups. The incidence of phrenic nerve palsy was significantly higher in the supraclavicular block group (30% vs. zero; P = 0.002).Ultrasound-guided axillary brachial plexus block combined with axillary nerve block can achieve similar anesthesia quality and outcome as supraclavicular brachial plexus block,and found to have similar success rates. Trial registratio: http://www.chictr.org.cn with the registration number of ChiCTR2200057906. Date of first trial of 21/03/2022.