Comparison of Supraclavicular, Infraclavicular, and Axillary Approaches for Ultrasound-Guided Brachial Plexus Block for Upper Limb Surgeries: A Retrospective Analysis of 182 Blocks

Abstract

Background: Supraclavicular (SCL), infraclavicular (ICL), and axillary (AX) brachial plexus nerve blocks are used for the upper extremity. Regional nerve blocks should be considered for their beneficial effects and less risk of complications. Objectives: The aim of this study was to conduct a retrospective evaluation of our experiences in ultrasound (US)-guided techniques of the SCL-ICL and AX approaches for brachial plexus block (BPB) in producing high-quality surgical anesthesia for operations below the shoulder. Methods: The records of 182 American Society of Anesthesiologists (ASA) grade I-III patients undergoing upper extremity and vascular surgeries under BPB by US guidance were evaluated. SCL, AX, and ICL approaches were used. A linear US probe was used for all patients. Data pertaining to demographic characteristics, ASA physical status, underlying diseases, block type, time between the block performance and the start of the operation, duration of the operation, type of surgeries, needle length, toxicity findings, postoperative complications, and success rates were assessed. Results: Demographic data were found to be similar with no statistically significant differences between the study groups (p > 0.05). The three groups were also similar in ASA physical status, type of surgery, the experience of the anesthesiologists who performed the blocks, the time between the end of the block performance and the start of the operation, and the quality of the surgical anesthesia. Transient Horner's syndrome was detected in 3 patients in the SCL group and in 1 patient in the ICL group. Conclusions: All three approaches can be used for US-guided BPB with adequate quality of surgical anesthesia.