We examined the outcomes and levels of patient satisfaction in 202 consecutive cases of ultrasound-guided supraclavicular brachial plexus block (SBPB) in upper limb surgery performed between September 2007 and March 2010.
All blocks were performed by orthopaedic surgeons using ultrasound visualisation with a high-frequency linear probe. The probe was placed in the coronal–oblique plane in the supraclavicular fossa, and the puncture was ‘in-plane’ from lateral to medial. Most of the blocks were performed with 0.75% ropivacaine/1% lidocaine (1:1), with or without adrenaline in 1:200 000 dilution. In 201 patients (99.5%) the brachial plexus block permitted surgery without conversion to general anaesthesia. The mean procedure time for block was 3.9 min (2 to 12), the mean waiting time for surgery was 34.1 min (10 to 64), the mean surgical time was 75.2 min (6 to 232), and the mean duration of post-anaesthetic analgesia was 437 min (171 to 992). A total of 20 patients (10%) developed a transient Horner’s syndrome. No nerve injury, pneumothorax, arterial puncture or systemic anaesthetic toxicity were recorded. Most patients (96.7%) were satisfied with ultrasound-guided SBPB. This study demonstrates the efficacy and safety of ultrasound-guided SBPB for orthopaedic surgery on the upper limb.
Cite this article: Bone Joint J 2014;96-B:795–9.
- Supraclavicular brachial plexus block
- Upper limb surgery
- Adverse effects
- Patient satisfaction
We thank S. Tsuji, MD, PhD at the Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, T. Kyo, MD, and S. Takenaka, MD, PhD at the Department of Orthopaedic Surgery, Bell Land General Hospital, for their contributions to this study.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by D. Rowley and first proof edited by A. Ross.
- Received February 20, 2013.
- Accepted January 31, 2014.
- ©2014 The British Editorial Society of Bone & Joint Surgery