Comparative study of using blind (Landmark technique) and USG guided brachial plexus block

Background: Brachial plexus block (BPB) is a safe, effective anesthesia technique for surgeries of the lower arm, forearm, and hand. It ensures optimal surgical conditions with complete muscle relaxation, stable intraoperative hemodynamics, sympathetic block, and prolonged postoperative analgesia. Ultrasound guidance, now standard, enhances the accuracy and safety of BPB, offering higher success rates and fewer complications than traditional methods.Aim of the study: This study aims to compare the effectiveness and success rate of blind (Landmark Technique) and ultrasound-guided approaches for supraclavicular brachial plexus blockMethods: This prospective observational study was conducted at the Department of Anesthesia in Satkhira Sadar Hospital, Satkhira Bangladesh from June 2023 to May 2024. Ninety patients, aged 18 to 65, scheduled for upper limb surgeries were included. Ethical approval and informed consent were obtained. Patients were randomly allocated into two groups: Group LM (Landmark) and Group US (Ultrasound) for supraclavicular brachial plexus block.Result: The average age and gender distribution were similar between groups, but the LM group had a higher mean weight. Procedure time was significantly shorter in the LM group (324±73 seconds) than in the US group (606±121 seconds). Sensory and motor block onset were faster in the US group, which also had longer durations of both blocks. The US group achieved a 100% success rate compared to 86.67% in the LM group, with no complications reported in the US group versus 15.56% in the LM group.Conclusion: The study finds ultrasound-guided supraclavicular brachial plexus blocks superior to the landmark technique, with a 100% success rate, faster sensory and motor block onset, longer anaesthesia duration, and no complications, compared to an 86.67% success rate and 15.56% complication rate in the landmark group, despite the longer procedural time.