A comparative study between usg guided classical interscalene block and low approach interscalene block in shaft humerus surgery

Abstract

Background:Classical interscalene approach of Brachial plexus block has become the anesthetic technique of choice in upper arm and shoulder surgery but one of the principal concerns is high risk of complications and sparing of C8-T1 nerve roots. Here we used low approach of interscalene block for shaft humerus surgeries. Previously none of the study compare USG guided LISB to the conventional approach for shaft humerus surgeries, Hence, this study was designed to compare onset, duration, density of sensory-motor block, severity of complication between ISB and LISB. Materials and Methods:Patients with fracture of shaft humerus at the age group of 18yrs- 55yrs of three hundred twenty four, ASA I and II patients, were randomly assigned into two groups I and L, where Classicle Interscalene block and Low Interscalene block were used, respectively. The primary objective of the study was to find out the difference in density of sensory-motor blockade and severity of complications if any, between the two groups, by using the Group differences were analyzed by parametric (t test) and nonparametric (Wilcoxon rank order test) tests; 2 was used for tests of independence.Results: At five minutes and fifteen minutes after the performance of the block, the degree of the block in the ulnar nerve was found to be 2.8 ± 2.6 and 1.1 ± 1.8, respectively, based on a ten-point scale. Motor block occurred in the median nerve after fifteen minutes in 151 patients out of 162 (92.8%), and in all of the other three nerves in all 162 patients. Horner syndrome and hoarseness were less frequent in LISB patients than in ISB patients (P 0.0009 and 0.003, respectively) which was statistically significant. Conclusion:The present study confirmed the achievement of an appropriate sensory and motor block in the shaft humerus surgery, including the ulnar nerve, fifteen minutes after LISB, with no complications than ISB.