Comparison Of The Ultrasound-guided Supraclavicular Brachial Plexus Block And The Interscalene Brachial Plexus Combined With Ulnar Nerve Block In Surgery On Ulnar Aspect Of The Hand

Objective:To compare the block time,complications,and anesthesia effect between ultrasound-guided supraclavicular brachial plexus block and interscalene brachial plexus combined with ulnar nerve block in surgery of ulnar aspect of the hand.Method:From April 2021 to January 2022,50 patients who underwent elective surgery on the ulnar aspect of the hand in the First Affiliated Hospital of Dali University were selected.The patients were randomly divided into supraclavicular block group（SCB group,n = 25）and interscalene brachial plexus combined with the ulnar nerve block（ISBPUB group,n = 25）.The onset time and recovery time of sensory,and motor block,the incidence of complications and the effect of anesthesia were recorded.Results: A total of 50 patients met the inclusion criteria of this study.2 patients in the SCB group were changed to general anesthesia and excluded from this study.Finally,the data of 48 patients were analyzed.The onset time of sensory block（2.9 ± 0.8min）and motor block（6.1 ± 1.2min）in the SCB group were shorter than ISBPUB group（5.4± 1.2min and 10.2 ± 2min）,and the duration of sensory block（539.5 ± 83.0min）and motor block（413.4 ± 68.6min）in the SCB group were longer than those ISBPUB group（467.2 ± 62.5min and 365.6 ± 57.5min）,and the difference between the two groups was statistically significant（P < 0.05）.In the SCB group,4 case had Horner’s syndrome,2cases had a vascular injury and 1 case had a tourniquet reaction.In the ISBPUB group,there were 1 cases of Horner’s syndrome,1 case of vascular injury,and 2 cases of tourniquet reaction.All patients had no complications such as pneumothorax,nerve injury,and local anesthetic systemic toxicity.In the SCB group,the blocking effect was excellent in 18 cases（72%）,good in 5 cases（10%）,and ineffective in 2 cases（8%）.In the ISBPUB group,24 cases（96%）had an excellent blocking effect,and 1 case（4%）had a good blocking effect.Conclusion:Ultrasound-guided supraclavicular brachial plexus block and interscalene brachial plexus combined with the ulnar nerve block both can provide satisfactory anesthetic effect in surgery on ulnar aspect of the hand.The most appropriate block method should be selected according to the patient’s condition,so as to obtain the best anesthetic effect and minimize the occurrence of complications.