Projects

Introduction: Ultrasound-guided brachial plexus blocks are
widely used to provide anaesthesia for upper limb surgery.
Costoclavicular Block (CCB) is a newer infraclavicular approach
to brachial plexus block where local anaesthetic is deposited
between the midpoint of the clavicle and the first rib.
Aim: To compare the efficacy of ultrasound-guided CCB to
Axillary Block (AXB) for below elbow surgery.
Materials and Methods: This randomised clinical study
included 70 patients belonging to ASA I and II category, aged
between 18 and 59 years undergoing below elbow surgery.
Patients were randomly allocated to either CCB group or
AXB group under ultrasound guidance using 20 mL of local
anaesthetic mixture (10 mL of 0.5% bupivacaine and 10 mL
of 2% lidocaine with adrenaline). Sensorimotor block onset
time, block performance time, total anaesthesia-related time,
success rate and complications were recorded. Independent
t-test was used to determine significance between two
quantitative variables and Fischer’s-exact test was used as
test of significance for qualitative data.
Results: Both groups were comparable in terms of demographic
data (age, sex, body mass index and American Society of
Anaesthesiologists (ASA) grading) with a p-value of >0.05. The
mean (SD) sensorimotor onset time was similar between the
CCB and AXB groups (14.71±1.18 vs 14.85±2.33 minutes),
respectively; p-value=0.764. Mean block performance time
was shorter in CCB than AXB group (5.83±0.82 vs 8.74±0.85
minutes) respectively; p-value <0.001. CCB group had a
shorter total anaesthesia-related time compared to AXB group
(20.69±0.87 vs 23.79±2.19 minutes) respectively. Success rate
was similar between costoclavicular and axillary approaches.
No complications were noted in either group.
Conclusion: Though the onset time and success rate were similar
between the two groups, CCB resulted in a shorter performance
time and total anaesthesia-related time. Thus, CCB is a safe and
reliable alternative to AXB for below elbow surgery.