Comparison of two techniques for supraclavicular nerve block ultrasound guided versus nerve stimulator block

Background: Providing adequate intraoperative anesthesia and postoperative analgesia in orthopedic patients has been a challenge for the anesthesiologists, keeping a choice between GA and RA. In case of RA blocks by landmark technique eliciting paresthesia has been associated with higher failure rates and complications. Brachial plexus block can be performed easily with use of nerve stimulators and with ultrasound guidance. The present study was conducted to compare the difference between the two techniques in patients undergoing upper limb surgeries with brachial plexus block.   
Methods: Total 100 patients enrolled and randomly allocated into N and U groups of 50 each, undergoing upper limb surgery. Supraclavicular Brachial Plexus Block, was administered using nerve stimulator in N Group and ultrasound guidance in U group. A 1:1 mixture of 0.5% Bupivacaine (up to a maximum of 2mg/kg body weight) and 2% Lignocaine (up to a maximum of 5mg/kg body weight) was used for achieving the block. Data collected and analyzed using relevant stastical tests.
Results: There was significant difference in time taken for performance of block and onset time between in U group as compared to the N group. The need for supplementation and complications were more in case of N group as compared to U group. There was no significant difference between the duration of sensory block in the two groups. 
Conclusion: The  results suggest that ultrasound guided brachial plexus block by supraclavicular approach are superior to NS guided blocks in terms of faster localisation ,onset of action, lesser complications and overall success rate of block.