Efficacy of Ultrasound Guided Supraclavicular Brachial Plexus Block Combined with Superficial Cervical Block in Shoulder Surgeries.

Background: Brachial plexus block is a useful alternative to general anesthesia for upper limb surgeries providing complete muscle relaxation and stable intra-operative hemodynamics. This study aimed to detect whether ultrasound guided supraclavicular brachial plexus block combined with superficial cervical plexus block is safe and effective for shoulder surgeries or not. Methods: A prospective clinical observational study for detecting efficacy of ultrasound guided supraclavicular brachial plexus block combined with superficial cervical plexus block in shoulder surgeries. Forty-two patients in the age group of 21-60 years undergoing shoulder surgery were assigned to one group. All patients received 30 mL volume of local anesthetics (Lidocaine 2% + bupivacaine 0.5% 1:3 mixture) for supraclavicular block and 10 mL volume of local anesthetics for superficial cervical block. All patients were assessed for: hemodynamics respiratory rate, O2 saturation, sensory block grade, motor block grade, postoperative pain, time for the 1st call for analgesia, the total dose of ketorolac (mg) given in 12 hours after surgery, incidence of failure of sensory and motor block and postoperative complications. Results: As regards mean arterial blood pressure, mean heart rate, oxygen saturation and respiratory rate there were no significant changes. Regarding sensory and motor block assessment, majority 95.2% had Bromage scale III and sensory block grade zero. As regard the postoperative pain, mild pain (VAS 2) occurred which was increasing gradually during 1st 12 postoperative hours. Conclusions: Ultrasound guided supraclavicular brachial plexus block combined with superficial cervical plexus block is safe and effective for shoulder surgeries. [ABSTRACT FROM AUTHOR]