Comparison of conventional and lateral approach to supraclavicular brachial block

Background: The conventional approach is many a time associated with complications such as vascular puncture, inadequate analgesia etc. The lateral approach is hypothesized to be equipotent and much safer than the conventional approach. We aim to evaluate this hypothesis. Method: After Institutional ethics committee clearance, the patients, after consenting, through computer generated block randomization, were allocated to either of the two groups - Group L or C. After the block, the duration for onset of sensory and motor blockade, the total duration of sensory& motor blockade and any complications were noted. A total of 60 patients were analyzed, 30 patients for the lateral approach and 30 patients for conventional approach. ASA 1 and 2 patients who were undergoing the surgeries of the upper limb were included in the study. Results: The incidence of complications was much higher in conventional approach as compared to the lateral approach with a p value 0f 0.041. In conventional approach, in 2 (6.7%) of the patients the block failed to act completely, inadequate block was seen in 7 (23.3%) of the patients of which vascular puncture was seen in 4 (13.3%) patients. In lateral approach, inadequate blockade was seen in 1 (3.3%) patient but there was no vascular puncture. Conclusion: Lateral approach is a much safer and reliable technique of supraclavicular brachial block.