Objective: A clinical study to decide whether ultrasound or nerve stimulator guided Interscalene Brachial Plexus Block is the superior method.

Material and Methods: A single blind controlled study was done on 60 patients between the age group of 18-60 years of ASA grade I or II undergoing upper limb surgery. Group A received Interscalene Brachial Plexus Block with 30ml of 0.5% Levobupivacaine using nerve stimulator alone, whereas group B received the same using two-dimensional ultrasonic image, with the secondary use of nerve stimulator after securing a correct needle position. Onset, duration and quality of both sensory and motor blockade were studied in both the groups.

Results: The time spent for detecting the brachial plexus, attempts in needle positioning and time taken in injecting the local anaesthetic was not significantly different between the groups. There was no significant difference in onset of sensory and motor blockade between two groups. The only significant difference was in the duration of the sensory and motor blockade. The mean duration of sensory blockade was 520.83 ± 11.60 minutes in group A and it was 585.96 ± 6.24 minutes in group B. Similarly the mean duration of motor blockade in group A was 415.6 ± 10.72 minutes and it was 474.6 ± 20.63 minutes in Group B.

Conclusion: It was concluded that ultrasound guidance in administering Interscalene Brachial Plexus Block prolongs the duration of sensory and motor blockade without any hemodynamic disturbances if the blocks are performed by anaesthesiologist who are experienced in both techniques.

Keywords: Levobupivacaine, Nerve Stimulator, Ultrasound, Interscalene brachial plexus block, Sensory and motor blockade.

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Dr Gopal Krishan

Associate Professor, Department of Anaesthesiology, RMCH Bareilly (U.P.) India

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