Comparison Of Ultrasound-guided Costoclavicular Space Approach And Axillary Approach For Brachial Plexus Block Anesthesia

ObjectivesTo compare and contrast the effects of ultrasound-guided Costoclavicular Space(CCS)access brachial plexus nerve block and ultrasound-guided axillary access brachial plexus nerve block on the operation time of the nerve block,anesthesia onset time,the maintenance time of the anaesthetic effect,the motor and sensory functions of the four branches of the brachial plexus nerve and other anaesthetic-related aspects in hand surgery,in order to provide a reference for the personalised selection of anaesthetic solutions in clinical practice.The study will provide a reference for clinical selection of anesthesia.MethodsIn this study,60 patients with ASA classification I-II and unilateral hand surgery were randomly divided into 2 groups.The number of patients successfully included in the analysis was 57,including 29 patients in group C and 28 patients in group F.The number of successful and failed blocks,anesthesia operation time T1,anesthesia onset time T2,anesthesia block maintenance time T3,four time points of 5,10,20 and 30 min after anesthesia,sensory and motor block of the four branches of the brachial plexus nerve,and the occurrence of adverse reactions within 24 h after anesthesia were recorded in the two groups,respectively.Results1.T1 of anesthesia operation time in both groups,T1 in group C was significantly shorter than that in group F(P < 0.05).There was no significant difference in the success rate of anesthetic block between the two groups(P > 0.05).2.The onset of anesthesia block time T2 in both groups,T2 in group C was significantly shorter than that in group F,and the difference between the two groups was significant(P < 0.05).3.The anesthesia block maintenance time T3 in both groups,the difference between CCS and axillary approach was not significant(P > 0.05).4.Comparison of sensory block anesthesia at different time points after anesthesia between the two groups:(1)Musculocutaneous Nerve(MCN): the success rate of sensory block was significantly higher in group C than in group F at four time points of 5,10,20 and 30 min after injection of local anesthetic(P < 0.05);(2)Radial Nerve(RN): block At 5 and 10 min after the completion of the operation,the effect of sensory block was significantly stronger in group C than in group F(P< 0.05);at the remaining two time points,the difference between the two groups was not significant(P > 0.05).(3)Median Nerve(MN): 5 and 10 min after the completion of block operation,the success rate of sensory block in group C was significantly higher than that in group F(P < 0.05);the difference between the two groups at the remaining two time points was not significant(P > 0.05).(4)Ulnar Nerve(UN): 5 and 10 min after the completion of block,the success rate of sensory block was significantly higher in group C than in group F(P < 0.05);for20 and 30 min,the difference between the two groups was not significant(P >0.05).5.Comparison of motor block anesthesia at different time points after block in two groups:(1)MCN: except for 5 min after the block operation was completed,there was no statistically significant effect of motor block in two groups(P > 0.05);at each time point of 10,20 and 30 min,the success rate of motor block in group C was significantly higher than that in group F(P < 0.05).(2)RN: There was no significant effect of motor block anesthesia in the two groups at 5,20 and 30 min after block completion(P > 0.05);at 10 min,the success rate of motor block in group C was significantly higher than that in group F(P < 0.05).(3)MN: Except for10 min,the success rate of motor block in group C was significantly higher than that in group F(P < 0.05);at the remaining time points,there was no statistically significant difference between the anesthetic effects of the two groups(P > 0.05).(4)UN: There was no statistically significant difference in the success rate of motor block between the two groups at 5,20 and 30 min after block(P > 0.05);only at the time point of 10 min,the success rate of motor block in group C was significantly higher than that in group F(P < 0.05).ConclusionCompared with the B-ultrasound-guided axillary approach,the CCS approach to the brachial plexus nerve block quickly achieves a higher success rate of sensory and motor block of the four branches of the brachial plexus nerve within 10 min after the injection of local anesthetic,and the CCS has unique advantages over the axillary approach to the brachial plexus nerve block.Compared with the axillary approach,the anesthetic block is performed in a shorter time,with faster onset of sensory and motor block,lower requirements for patient positioning,and higher patient satisfaction.