The aim of the study is to compare the onset time of the costoclavicular approach of brachial plexus block with that of the lateral-sagittal infraclavicular approach in adults distal upper limb surgeries.
ASA physical status I-III
Distal upper limb surgery requiring brachial plexus block.
Patient approval after written and informed consent to participate.
Patient refusal.
Allergy to drugs used.
Infection at puncture site.
Coagulopathy or anticoagulant therapy.
Parallel
Costoclavicular brachial plexus block
Procedure/SurgeryUltrasound-guided costoclavicular brachial plexus block performed using a high-frequency linear probe. A mixture of 2% lidocaine and 0.5% bupivacaine (1:1 ratio) with a total volume of 0.3 mL/kg is injected in the costoclavicular space around the cords of the brachial plexus under real-time ultrasound guidance.
Lateral-sagittal infraclavicular brachial plexus block
Procedure/SurgeryUltrasound-guided lateral-sagittal infraclavicular brachial plexus block performed using a high-frequency linear probe. A mixture of 2% lidocaine and 0.5% bupivacaine (1:1 ratio) with a total volume of 0.3 mL/kg is injected around the cords of the brachial plexus under real-time ultrasound guidance.
Time to onset of complete sensory and motor block
Time from completion of local anesthetic injection to achievement of complete sensory and motor blockade. Sensory block will be assessed using pinprick testing in the distributions of the median, ulnar, radial, and musculocutaneous nerves. Motor block will be graded using a standardized motor scale. And time will be in minutes and seconds.
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