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Arch Hand Microsurg > Volume 19(3); 2014 > Article
Journal of the Korean Society for Surgery of the Hand 2014;19(3):130-135.
Published online September 30, 2014.
DOI: https://doi.org/10.12790/jkssh.2014.19.3.130   
Comparison of Axillary and Supraclavicular Approach in Ultrasound-Guided Brachial Plexus Block
Bo Byoung Seo, Young Woo Kim, Jong Min Kim, Mi Young Lee, Young Ho Jang, Sang Hyun Woo
1Department of Anesthesiology and Pain Medicine, W Hospital, Daegu, Korea.
2Cheon & Woo's Institute for Hand & Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com
3Department of Preventive Medicine, Keimyung University School of Medicine, Daegu, Korea.
4Institute of Cancer Rehabilitation and Convalescence, Yoonsung Hospital, Cheongdo, Korea.
Received: 30 July 2014   • Revised: 2 September 2014   • Accepted: 4 September 2014
Abstract
Purpose
We examined the success rate and adverse effects of ultrasound-guided axillary and supraclavicular approach brachial plexus block.

Methods
From December 2013 to February 2014, 580 cases of patients received ultrasound-guided axillary approach or supraclavicular approach brachial plexus block. All blocks were performed by one anesthesiologist under ultrasound visualization using 0.2% or 0.75% ropivacaine 1% lidocaine with epinephrine in 1:200,000 as the anesthetic mixture.

Results
Failure rate of ultrasound-guided brachial plexus block was 1.2% and 0.2% in axillary and supraclavicular approach, respectively. In supraclavicular approach brachial plexus block, Honer's syndrome was observed in 17.9%, chest discomfort in 14.9%, and arterial puncture in 1%. There was no adverse effect in axillary approach brachial plexus block.

Conclusion
Ultrasound-guided brachial plexus block serves higher success rate and lower occurrence rate of adverse effect and makes it useful for hand and upper extremity surgery. Supraclavicular approach has relatively higher success rate and lower rate of adverse effect than axillary approach.
 
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