Comparison of Brachial Plexus Block Performed by Axillary Approach and Coracoid Infraclavicular Block for Upper Limb Surgery: A Clinical Study

Brachial Plexus Block for Upper Limb Surgery

Abstract

Background: PNBs (Peripheral Nerve Blocks) have a vital role with increasing attention in subjects undergoing ambulatory anesthesia. PNBs also have properties near to ideal anesthesia in Outpatient surgical cases. It is also associated with facilitated discharge and postoperative analgesia. The aims of the present study were conducted to compare the efficacy of brachial plexus block given by Coracoid infraclavicular route or axillary route with peripheral nerve stimulator concerning success and failure rates, block duration, motor block intensity, onset, and performance time. Subjects and Methods: The study included a total of 50 subjects from both genders divided into two groups of 25 subjects each given brachial plexus block using either coracoid route or axillary route. The local anesthetic agent used was 2% lidocaine with 0.5% bupivacaine mixed in equal parts for all the subjects. Results: It was seen that the axillary approach was better in efficacy concerning few incomplete blocks, more comfort, less pain, long duration, more intensity, and fast onset with 4 injections of local anesthetic agents compared to the two injections used in the coracoid approach. The long duration helped in achieving better postoperative analgesia. However, the coracoid approach was advantageous in subjects with arthritis and stiff shoulder joints as it could be given in an arm in a neutral position. Conclusion: The present study concludes that the axillary approach using four injections is more efficacious than two injections of the coracoid approach in terms of long duration, faster onset, and better analgesia.