Success Rate and Safety of Ultrasound-Guided Supraclavicular Brachial Plexus Blocks; A Retrospective Study of 1,830 Cases

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Wanwisa Sinthuprasit


Background: Currently, the supraclavicular brachial plexus block ultrasound-guided technique is used to replace the paresthesia technique. The technique allows the visualization of the needle and the distribution of anesthetic around the nerves. It reduces the duration of the procedure and complications following the procedures. Objective: To study the success and complications of ultrasound-guided supraclavicular brachial plexus blocks in Khon Kaen Hospital. Methods:A study of the patients who received ultrasoundguided supraclavicular brachial plexus blocks for arm, wrist, and hand surgery at Khon Kaen Hospital from 2017 to 2019. The data was collected on success, and complications following the procedure, type and amount of local anesthesia used, and the supplemental medication that the patient receives. Results: A total of 1,830 patients, 1,660 patients (90.71%) were classified as successful, while 184 patients (9.92%) were classified as failed, of which 91 patients received an additional nerve block 31 patients received ulnar nerve block, 46 patients received axillary nerve block, and 93 patients (5.08%) switched to general anesthesia. A total of 434 patients (26.14%) received additional supplemental therapy which the most commonly used medications were 0.5%bupivacaine or 0.5%levobupivacaine mixed with 2% lidocaine with adrenalin 1:200,000. The dose was 15-35 millimeters without complications in this study. Conclusion: The ultrasound-guided supraclavicular brachial plexus blocks had a high success rate (90.71%) and reduced the likelihood of complications following the procedures.

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Original articles


1. The New York School of regional anesthesia (NYSORA).
Ultrasound-guided supraclavicular brachial plexus nerve
block [Internet]. [Cited 6 June 2021]. Available from: https://
2. Sathyan N, Hegde H, Padmanabha S, Anish KA. Brachial
plexus block. A comparison of nerve locator versus
paresthesia technique. IORS-JDMS 2014;13:6-10.
3. Franco CD, Vieira ZE. 1,001 subclavian perivascular brachial
plexus blocks: success with a nerve stimulator. Reg Anesth
Pain Med 2000;25:41-6.
4. Yuan JM, Yang XH, Fu SK, et al. Ultrasound guidance for
brachial plexus block decreases the incidence of complete
hemi-diaphragmatic paresis or vascular punctures and
improves success rate of brachial plexus nerve block
compared with peripheral nerve stimulator in adults. Chin
Med J (Engl) 2012;125:1811-6.
5. Honnannavar KA, Mudakanagoudar MS. Comparison
between conventional and ultrasound-guided supraclavicular
brachial plexus block in upper limb surgeries. Anesth Essays
Res 2017;11:467-71.
6. Williams SR, Chouinard P, Arcand G, et al. Ultrasound guidance
speeds execution and improves the quality of supraclavicular
block. Anesth Analg 2003;97:1518-23.
7. Gupta PK, Hopkins PM. Regional anaesthesia for all? Br J
Anaesth 2012;109:7-9.
8. Cook TM, Counsel LD, Wildsmith JA. Major complications of
central neuraxial block: report on the Third National Audit
Project of the Royal College of Anaesthetists. Br J Anaesth
9. Marhofer P, Harrop-Griffiths W, Willschke H, Kirchmair L.
Fifteen years of ultrasound guidance in regional anaesthesia:
Part 2- Recent developments in block techniques. Br J
Anaesth 2010;104:673-83.
10. Chan VWS, Perlas A, Rawson R, et al. Ultrasound-guided
supraclavicular brachial plexus block. Anesth Analg
11. Tsui BCH, Doyle K, Chu K, et al. Case series: ultrasoundguided supraclavicular block using a curvilinear probe in
104 day-case hand surgery patients. Can J Anesth 2009;56:
12. Neal JM, Moore JM, Kopacz DJ, et al. Quantitative analysis
of respiratory, motor, and sensory function after supraclavicular
block. Anesth Analg 1998;86:1239-44.
13. Gamo K, Kuriyama K, Higuchi H, et al. Ultrasound-guided
supraclavicular brachial plexus block in upper limb surgery.
Bone Joint J 2014;96:795-9.
14. Duggan E, Beheiry HE, Perlas A, et al. Minimum effective
volume of local anesthetic for ultrasound-guided supraclavicular
brachial plexus block. Reg Anesth Pain Med 2009;34:215-8.
15. Bao X, Huang J, Feng H, et al. Effect of local anesthetic
volume (20 mL vs 30 mL ropivacaine) on electromyography
of the diaphragm and pulmonary function after ultrasoundguided supraclavicular brachial plexus block: a randomized
controlled trial. Reg Anesth Pain Med 2019;44:69-75.
16. Franco CD, Gloss FJ, Voronov G, Tyler SG, Stojiljkovic LS.
Supraclavicular block in the obese population: ananalysis of
2020 block. Anesth Analg 2006;102:1252-4.