Ultrasound guided supraclavicular block versus combined infraclavicular and Suprascapular block: A randomized controlled trial

The infraclavicular block (ICB) can avoid some of the side effects of the supraclavicular block (SCB) like hemi-diaphragmatic palsy. This study aimed to analyze the comparative efficacy of supraclavicular block versus combined infraclavicular block and suprascapular block. Patients undergoing upper limb surgery under general anaesthesia were randomized into group S (to receive supraclavicular brachial plexus block) and group I (to receive infraclavicular brachial plexus block and suprascapular nerve block). Onset times and the duration of both sensory and motor block was noted in both the groups. Postoperative pain as assessed by NRS score and total fentanyl requirement was noted for 24 hours. : The group S showed a significantly faster onset of both sensory (8.47±3.12) vs. 13.75±4.69; p<0.001) and motor blocks (15.56±5.32 vs. 24.17±5.67; p<0.001). The duration of sensory block was significantly greater in the group I, with no significant difference in the duration of motor block.We also noted hemi diaphragmatic paresis (27.8%) and paralysis (8.3%) only in the SCB group. For the patients undergoing upper limb surgeries, the use of ICB+SSB block as compared to the SCB block resulted in increased duration of sensory block; however, the fentanyl consumption was not significantly reduced.