Comparison of Two Techniques of Brachial Plexus Block for Upper Limb Surgeries in a Nigerian Teaching Hospital

Abstract

The study compared trans-arterial approach and mid-humeral technique of axillary brachial plexus block in terms of the clinical benefit of each method; adequacy of block, onset of sensory and motor block, duration of block and complications. .In a prospective randomized study, axillary plexus block was carried out in 50 patients undergoing surgery on the hand or forearm. Trans-arterial approach was used in 24 patients while 26 patients had a mid-humeral axillary plexus block. Equal volume, 40ml of 0.5% plain Bupivacaine was used in both groups. Sensory function was tested using pin-prick. Motor function was assessed using a modified bromage scale. Onset and duration of sensory and motor blockade, duration of analgesia and adverse side effects were compared. Earlier onset of sensory block was seen in the patients who had mid-humeral block (Group B) 13 + 3.2 (min) compared with those in (group A) Trans-arterial block 22 + 4.1 (min). A higher success rate was recorded in (group B) 96.15% versus 70.8% in (group A) as well as less incidence of adverse side effects. Mid-humeral technique of axiliary block ensures early establishment of analgesia with less adverse side-effects when compared with the trans-arterial method.

Keywords: Axillary, Brachial Plexus Block, Trans-Arterial, Mid-Humeral, Techniques.

Nigerian Medical Practitioner Vol. 53 (1&2) 2008: pp. 15-18