Comparison of landmark technique versus ultrasound guided technique for supraclavicular brachial plexus block in upper limb surgeries: A prospective randomized trial

Abstract

: Brachial plexus block is a widely used regional anaesthesia technique for upper limb surgeries, with regional techniques gaining popularity over general anaesthesia. Recent advancements in anatomical sonography have improved the understanding and application of ultrasound-guided techniques. Ultrasound enables accurate needle placement /and real-time monitoring of drug distribution, enhancing the effectiveness and safety of the procedure.: The objective of this study is to compare the effectiveness of supraclavicular brachial plexus block using the landmark technique and ultrasound-guided technique in terms of procedure time, onset and duration of sensory and motor blockade, effectiveness of the block, and complication rate. This prospective, randomized controlled study included 60 patients aged between 18 and 60 years, of either sex, belonging to ASA grade I and II, and undergoing elective or emergency upper limb surgeries (elbow, forearm, and hand surgeries). The patients were divided into two groups: Group LM (Landmark technique) and Group US (Ultrasound technique). Each patient received a supraclavicular brachial plexus block using either technique with 25ml of 0.5% ropivacaine, and relevant parameters were recorded.: The success rate was higher in Group US compared to Group LM, and no complications were observed. The onset of blockade was significantly faster, and the duration of the block was longer with the ultrasound-guided technique compared to the landmark technique. However, the time taken to administer the block was longer with the ultrasound technique.: Ultrasound-guided supraclavicular block is a safer technique with a higher success rate, providing more effective and prolonged block compared to the conventional landmark technique.