Comparative study between nerve stimulator guided technique and ultrasound guided technique of supraclavicular nerve block for upper limb surgery

Background: Peripheral nerve stimulator (PNS) has been the ‘gold standard’ for peripheral nerve blocks for determining adequate needle placement to produce regional anesthesia/analgesia. Modern ultrasound (US) machines can be used to guide the injection needle while minimizing the risk of injury of adjacent structures.the main objective of the study was to compare nerve stimulator guided technique and ultrasound guided technique of supraclavicular brachial plexus block for upper limb surgeryMethods: This prospective randomized single blind comparative study was conducted in eighty patients under supraclavicular brachial plexus block using 0.5% Ropivacaine at a tertiary care teaching hospital of Rajasthan after taking approval from ethical committee. These patients were randomly allocated in either group PNS (n=40) or group US (n=40). Both the groups were assessed for procedure time, onset and duration of sensory and motor blockade and complications. Results: The procedure time was 8.0±1.53 minutes in group PNS and 6.27±1.10 minutes in group US (p˂0.0001). The onset of sensory and motor block was 7.68±1.33 minutes and 9.94±1.28 minutes in group PNS and 6.46±1.02 minutes and 8.10±1.02 minutes respectively in group US (p˂0.0001). The time to achieve complete block was 16.11±1.54 minutes in group PNS and 13.74±1.11 minutes in group US (p˂0.0001). The duration of sensory and motor block was 7 hours and 6 hours for group PNS and 8 hours and 7 hours respectively in group US. The success rate was 90% in group PNS and 97.5% in Group US.Conclusion: Ultrasound guided technique was found significantly better than PNS for supraclavicular brachial plexus block.

Comparative analysis of Magnesium Sulphate Versus Clonidine as an Adjuvant to Epidural Bupivacaine 0.5% in Lower Abdominal and Lower Limb Surgeries

Introduction: A prospective, randomized, controlled clinical trial was carried out to evaluate the effects ofMagnesium sulphate as an adjuvant to epidural bupivacaine and compared with clonidine along with epidural bupivacaine.Aims and Objective: Main objective to evaluate the efficacy of epidural magnesium sulphate& clonidineused as an adjuvant to bupivacaine.Material and method: After approval from institutional ethical committee 60 patients undergoing lowerabdominal &lower limb surgeries selected and divided in 2 groups Clonidine group and Magnesium group and different parameters observed.Observation: Co-administration of inj. Magnesium sulphate 50 mg. or Clonidine 3μg/kg (150μg maximum) to epidural bupivacaine produced predictable rapid onset of surgical anaesthesia without significant side effects. Addition of clonidine to epidural bupivacaine produced prolonged duration of analgesia with mild sedation compared to magnesium sulphate.Conclusion: From the study it is suggested that magnesium sulphate can be a useful alternative as anadjuvant to epidural bupivacaine without any side effects