Online ISSN: 2515-8260

Keywords : upper limb surgeries

Comparative study of supra clavicular and interscalene block for proximal humerus fractures

Dr. Venkatesh Subramanyam, Dr. Azmatulla Shaik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 198-203

Introduction: Supraclavicular brachial plexus block could be an alternative and provide comparable
effective anaesthesia and postoperative analgesia for shoulder surgery. Interscalene brachial plexus
blockade is the standard nerve block for analgesia after arthroscopic and open shoulder surgery.
Material and Methods: This is a Prospective, observational and descriptive study conducted in the
Department of Anaesthesia at Nimra Institute of Medical Sciences (NIMS) over a period of 1 year. These
patients were divided into two groups by simple random method; the patients were divided into group
IRD (interscalene block using 30 ml of ropivacaine 0.5% + 50 μg of dexmedetomidine) and another
group (supraclavicular block using 30 ml of ropivacaine 0.5% + 50 μg of dexmedetomidine). The
procedure was conducted using nerve stimulator technique.
Results: The mean time of the onset of sensory block in supraclavicular group was 3.50±0.83, in
interscalene was 3.1±0.62 and onset of motor block (min) was 3.60±0.62 in supraclavicular group, in
interscalene was 3.21±0.54. The duration of sensory block was 495.53±49.41 min and 759.42±84.15 min
in supraclavicular group and interscalene block respectively. Moreover, duration motor block (min) in
supraclavicular group was 438.52±47.32, in interscalene was 659.23±38.74.
Conclusions: The onset of sensory and motor block was significantly faster in interscalene techniques
then supraclavicular. Prolonged duration of sensory and motor block followed by interscalene and
supraclavicular approaches, respectively.

Study to assess the effectiveness of Ropivacaine versus Ropivacaine plus Fentanyl combination in Brachial Plexus block by supraclavicular approach

Dr. Padmalatha Seelam, Dr. Manoj Patruni, Dr. Vengamamba Thummala, Dr. Vadlamudi Rajesh Kumar, Dr. Nalli Venkata Krishna Mallik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1597-1607

Introduction: One of the primary aims of anesthesia is to relieve the patient's pain and
agony, thereby the surgical procedures can be conducted without any discomfort. Relief of
intraoperative and postoperative pain has gained importance in recent years, considering the
central, peripheral and immunological stress response to tissue injury. Any expertise acquired
in this field should be extended into the postoperative period, which is the period of severe,
intolerable pain requiring attention. So there is need of extended analgesia without any side
effects in the process of achieving this goal. “Regional anaesthesia” is the term first used by
Harvey Cushing in 1901 to describe pain relief by nerve block 1. Regional nerve blocks are
based on the concept that pain stimulus conveyed by nerve fibers, which are amenable to
interruption anywhere along their pathway 2. Brachial plexus block is a valuable and safe
alternative to general anesthesia in upper limb surgeries. Interrupting the acute pain which
can help in limiting the development of chronic pain syndromes 3, 4. The effects of opioids on
regional blockade is controversial. So the present study is being undertaken to evaluate
Fentanyl as an adjuvant to Ropivacaine in supraclavicular brachial plexus block.
Methodology: Hospital based Prospective randomized single blinded study. Conducted on
eighty patients of ASA I and II posted for upper limb surgeries under supraclavicular block.
Patients were divided randomly by means of random number table generated by computer
into two groups as A and B. Each group consisting of 40 patients. Prior to the study
Institutional Ethical committee approval and consent from the patients were taken. The study
was conducted in the Department of Anesthesiology, at Katuri medical college &Hospital,
Guntur from January 2016 to October 2017.