3. ULTRASOUND GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB FRACTURE OR DISLOCATION REDUCTION IN EMERGENCY DEPARTMENT

Harshad Wankhade, Vishwa P Chauhan, Reena Parikh, A. K. Saxena

ABSTRACT

Background & Objective: To establish the role of ultrasound guided supraclavicular brachial plexus block in emergency department for upper limb fracture reduction and or dislocation. Method: This was the perspective observational study conducted in the emergency department. It includes 40 consecutive patients presented to the ED with upper limb fracture or dislocation. Written inform consent was taken and ultrasound guided supraclavicular brachial plexus block performed. We evaluated the time to perform the block accuracy of drug delivery, volume of drug used, onset, extent and duration of sensory and motor block. Result: Ultrasound guided supraclavicular brachial plexus block can be easily learned by emergency physician with minimal training and can be performed in emergency room within 12+_3 minutes. Because of it has high level of safety than conventional technique, its complication rate was observed to be 0%. Its simplicity and capacity of rapidly achieving the block helps in decreasing effective length of stay of patient in emergency room and improving the point of care. Mean volume of drug used was 15+_3 ml which is less than conventional technique. Mean duration of onset of sensory blockage was 8.75+_2.47 min, duration of post block analgesia was 371.25+_31.11 min. Conclusion: Ultrasound guided brachial plexus block have high success rate and low complication rate . It has shown promise in terms of time duration while performing block and hence should be added in the armamentarium of emergency medicine department.

Key-words: Supraclavicular block, Ultrasonography, Bupivacaine.

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