Comparative study between nerve stimulator guided technique and ultrasound guided technique of supraclavicular nerve block for upper limb surgery

Background: Peripheral nerve stimulator (PNS) has been the ‘gold standard’ for peripheral nerve blocks for determining adequate needle placement to produce regional anesthesia/analgesia. Modern ultrasound (US) machines can be used to guide the injection needle while minimizing the risk of injury of adjacent structures.the main objective of the study was to compare nerve stimulator guided technique and ultrasound guided technique of supraclavicular brachial plexus block for upper limb surgery Methods: This prospective randomized single blind comparative study was conducted in eighty patients under supraclavicular brachial plexus block using 0.5% Ropivacaine at a tertiary care teaching hospital of Rajasthan after taking approval from ethical committee. These patients were randomly allocated in either group PNS (n=40) or group US (n=40). Both the groups were assessed for procedure time, onset and duration of sensory and motor blockade and complications. Results: The procedure time was 8.0±1.53 minutes in group PNS and 6.27±1.10 minutes in group US (p˂0.0001). The onset of sensory and motor block was 7.68±1.33 minutes and 9.94±1.28 minutes in group PNS and 6.46±1.02 minutes and 8.10±1.02 minutes respectively in group US (p˂0.0001). The time to achieve complete block was 16.11±1.54 minutes in group PNS and 13.74±1.11 minutes in group US (p˂0.0001). The duration of sensory and motor block was 7 hours and 6 hours for group PNS and 8 hours and 7 hours respectively in group US. The success rate was 90% in group PNS and 97.5% in Group US. Conclusion: Ultrasound guided technique was found significantly better than PNS for supraclavicular brachial plexus block.