Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study

Background: The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased...

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Main Authors: Suresh Kumar Vallapureddy, Gajanan Fultambkar, V. Rajeswar Rao, Vinay Kukreja, Rammohan Gurram, Abhijit Nair
Format: Article
Language:English
Published: Knowledge E 2021-07-01
Series:Dubai Medical Journal
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Online Access:https://www.karger.com/Article/FullText/517357
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author Suresh Kumar Vallapureddy
Gajanan Fultambkar
V. Rajeswar Rao
Vinay Kukreja
Rammohan Gurram
Abhijit Nair
author_facet Suresh Kumar Vallapureddy
Gajanan Fultambkar
V. Rajeswar Rao
Vinay Kukreja
Rammohan Gurram
Abhijit Nair
author_sort Suresh Kumar Vallapureddy
collection DOAJ
description Background: The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. Methods: After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. Results: The demographic data were comparable between both groups. The DI group had a significantly faster onset than the SI group (p = 0.0172). There was a statistically significant lesser performance time in group SI than in group DI (p < 0.034). The sensory and motor block achieved was comparable between both groups. Conclusion: The success rates in both the SI and DI techniques are comparable. The DI technique results in a faster onset and hence a shorter TART; however, it may not be clinically relevant.
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spelling doaj-art-1d030a4466ca472dbc56d83ed377ca9c2025-08-20T02:44:07ZengKnowledge EDubai Medical Journal2571-726X2021-07-011610.1159/000517357517357Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled StudySuresh Kumar Vallapureddy0Gajanan Fultambkar1V. Rajeswar Rao2Vinay Kukreja3Rammohan Gurram4Abhijit Nair5Department of Anesthesiology, Yashoda Hospital, Secunderabad, IndiaDepartment of Anesthesiology, Yashoda Hospital, Secunderabad, IndiaDepartment of Anesthesiology, Yashoda Hospital, Secunderabad, IndiaDepartment of Anesthesiology, Yashoda Hospital, Secunderabad, IndiaDepartment of Anesthesiology, Yashoda Hospital, Secunderabad, IndiaDepartment of Anesthesiology, Ibra Hospital, Ibra, OmanBackground: The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. Methods: After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. Results: The demographic data were comparable between both groups. The DI group had a significantly faster onset than the SI group (p = 0.0172). There was a statistically significant lesser performance time in group SI than in group DI (p < 0.034). The sensory and motor block achieved was comparable between both groups. Conclusion: The success rates in both the SI and DI techniques are comparable. The DI technique results in a faster onset and hence a shorter TART; however, it may not be clinically relevant.https://www.karger.com/Article/FullText/517357acute painbrachial plexusregional anesthesiasupraclavicular blockultrasonography
spellingShingle Suresh Kumar Vallapureddy
Gajanan Fultambkar
V. Rajeswar Rao
Vinay Kukreja
Rammohan Gurram
Abhijit Nair
Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
Dubai Medical Journal
acute pain
brachial plexus
regional anesthesia
supraclavicular block
ultrasonography
title Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
title_full Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
title_fullStr Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
title_full_unstemmed Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
title_short Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study
title_sort comparison between single and double injection technique for ultrasound guided supraclavicular block a randomized controlled study
topic acute pain
brachial plexus
regional anesthesia
supraclavicular block
ultrasonography
url https://www.karger.com/Article/FullText/517357
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