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Comparison of Nerve Stimulator Guided and Ultrasound Guided Interscalene Brachial Plexus Block in Shoulder Surgery

Dhiraj Bhandari, Department of Anesthesiology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra 442102, India. , Sucheta Tidke1 , Divya Choudhary2 , Sunil Tidke3 , Dhiraj Bhandari4 , Benhur P5 , Sudha Jain6

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Indian Journal of Anesthesia and Analgesia 8(3):p 349-356, May-June 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.50

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Sucheta Tidke, Divya Choudhary et al./Comparison of Nerve Stimulator Guided and Ultrasound Guided Interscalene Brachial Plexus Block In Shoulder Surgery/Indian J Anesth Analg. 2021; 8(3): 349-356.
 

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Introduction: This study was conducted to compare the two techniques, Nerve stimulator guided and Ultrasound guidance for Interscalene brachial plexus block in shoulder and upper arm surgeries. Methods: Total 80 patients were included in our study which were randomly allotted by sealed envelope technique two groups namely US-guided (Group US) or NS-guided (group NS). The drug mixture of 0.375% bupivacaine and 0.5% lignocaine with 1:200000 adrenaline was used. Results: Comparison between the Nerve Stimulator (NS) and Ultrasound guided (US) technique of interscalene brachial plexus block revealed that the number of pricks(1-77.5%, 2-20%, 3-2.5% in US group and 1-52.5%, 2-35%, 3-12.5% in NS group), block execution time (5.32(0.50) min in US and 7.10 (0.62) min in NS group), time of onset of sensory and motor block was significantly less in US group ascompare to NS groups. The recovery from sensory (11.9 (1.19) hrs in US and 8.74(0.71) hrs in NS, p=0.0001) and motor block (6.76(0.63) hrs in US and 5.35 (0.48) hrs in NS group, p=0.001) also was significantly longer US group than in NS group. VAS scores were significantly lower in group US group than in NS group in post operative periods. The incidence blockade failure requiring general anesthesia was not significant. Block was successful in 95% of cases in US group and 85% of cases in NS group. Conclusion: Effective quality of the block, execution time, onset of sensory and motor block, recovery from sensory and motor block and VAS scores were more satisfactory with ultrasound technique than the nerve stimulator technique.

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Sucheta Tidke, Divya Choudhary et al./Comparison of Nerve Stimulator Guided and Ultrasound Guided Interscalene Brachial Plexus Block In Shoulder Surgery/Indian J Anesth Analg. 2021; 8(3): 349-356.
 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.50

Keywords

Interscalene block; Nerve stimulator; USG guidance.

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