Ultrasound-Guided The Coracoid Infraclavicular And The Interscalene Brachial Plexus Block For Upper Extremity Surgery

Objective:The aim of this study was to compare the ultrasound-guided coracoid infraclavicular and interscalene brachial plexus block anesthesia for upper extremity surgery.Methods:60patients undergoing upper extremity surgery were divided into2equal groups randomly:Coracoid infraclavicular group (Group C) and interscalene group(Group I). The patients in Group C received ultrasound-guided coracoid infraclavicular brachial plexus block and the patients in Group I received ultrasound-guided interscalene brachial plexus block. Pulse oxygen saturation, respiratory rate, mean arterial pressure and heart rate were monitored at different time points:entered the operating room when before nerve block (TO), finished brachial plexus block after15minutes (T1), the moment when cutting the skin (T2), finished brachial plexus block after1hour (T3) and surgery end time (T4).The block operation time, the sensory block onset time of the seven terminal nerves, the sensory block latency time, the perioperative Numerical Rating Score (NRS), blocking effect, tourniquet pain and adverse events were recorded.Results:1.There was no significant difference in two groups’ age, height, weight and surgical data(P>0.05).2. The underlying value of SpO2, RR, MAP and HR in two groups were not statistically significant (P>0.05);3.Group C had more needle times and longer block operation time than Group I (P<0.05).4.The ulnar, median, medial antebrachial cutaneous and medial brachial cutaneous nerves’onset time and the10min after the block effect of Group C were significantly superior than the Group I (P<0.05).5. Tourniquet pain of Group C was significantly fewer than the Group I (P<0.05).6. Both two groups could achieve surgical analgesic requirements. The rates of complete sensory block were similar (Group C:80%,Group I:63.6%; P>0.05). There was no significant difference in the perioperative NRS, block effectiveness and adverse events (P>0.05).Conclusion:Ultrasound-guided coracoid infraclavicular and interscalene brachial plexus block was effective and safe method for the upper extremity. The coracoid infraclavicular brachial plexus block tourniquet reactions occure less, and the interscalene brachial plexus block operated simpler.