An Observational Study of Efficacy of Infraclavicular Brachial Plexus Block for Arterio-Venous Fistula Surgeries- Comparison of Two Techniques Using Ultrasound and Ultrasound with Peripheral Nerve Stimulation

Vol 3 | Issue 2 | July-December 2022 | Page 88-92 | Trupti Pethkar, R. Janki

DOI: 10.13107/ijra.2022.v03i02.060

Authors: Trupti Pethkar [1], R. Janki [1]

[1] Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.

[2] Critical Care Department, Caritas Hospital, Kottayam, Kerala, India.

Address of Correspondence
Dr. Trupti Pethkar,
Consultant Anesthesiologist, Department of Anaesthesia, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.


Background: Success of the brachial plexus block depends equally on the performer’s skill and the availability of specific equipments. Here, the efficacy of infraclavicular brachial plexus block was assessed using two different techniques.
Material and Methods: In 72 patients divided in equal groups, the time taken to perform the block, onset and degree of sensory and motor blockade, complications and supplements, if required were noted in patients undergoing arterio-venous fistula creation. An infraclavicular brachial plexus block was performed either with ultrasound only (group-A) or with ultrasound and nerve stimulation (group-B). Collected data underwent rigorous statistical analysis.
Results: Onset of sensory, motor blockade and block success achieved in both groups was statistically insignificant. Time taken for block administration and the mean time for complete sensory blockade were statistically significant.
Conclusion: Though time taken for the block administration was longer and complete sensory blockade was earlier by dual guidance, the block success rate and the degree of block were comparable in both the techniques. Dual modality blocks are challenging in view of obtaining an evoked motor response and visualization of the needle at the same time.
Keywords: Infraclavicular brachial plexus block, Sonosite, Peripheral nerve Stimulator


1. Emmannuel Dingemans, Stephan R. Williams, Genevie `ve Arcand, Philippe Chouinard, Patrick Harris, Monique Ruel, RN* Franc ¸ois Girard et al. Neurostimulation in ultrasound guided Infraclavicular Block: A Prospective Trial. Anaesth Analg 2007; 104; 1275-80.
2. Y. Gürkan, M. Tekin, S. Acar, M. Solak and K. Toker. Is nerve stimulation needed during an ultrasound-guided lateral sagittal infraclavicular block? Acta Anaesthesiol Scand 2010; 54: 403–407.
3. FMT Azmin & YC Choy. Regional infraclavicular blocks via the coracoid approach for below-elbow surgery: a comparison between ultrasound guidance with, or without, nerve stimulation, South Afr J Anaesth Analg 2013, 19(5):263-269.
4. Shrestha BR. Nerve Stimulation Under Ultrasound Guidance Expedites Onset of Axillary Brachial Plexus Block. J Nepal Health Res Counc 2011 Oct; 9(19):145-49.
5. Bloc S, Garnier T, Komly B, Leclerc P, Mercadal L, Morel B, Dhonneur G. Ultrasound-guided infraclavicular block: a preliminary study of feasibility. Ann Fr Anesth Reanim 2007; 26: 627–37.
6. Chan VWS, Perlas A, McCartney CJL, Brull R, Xu D, Abbas S. Ultrasound guidance improves success rate of axillary brachial plexus block. Can J Anaesth. 2007; 54: 176-182.
7. Richard Brull, MD Æ Mario Lupu, MD Æ Anahi Perlas, MD Æ Vincent W. S. Chan, MD Æ Colin J. L. McCartney, MB. Compared with dual nerve stimulation, ultrasound guidance shortens the time for infraclavicular block performance.Can J Anaesth 2009 Nov; 56(11): 812-8.

How to Cite this Article: Pethkar T, Janki R | An Observational Study of Efficacy of Infraclavicular Brachial Plexus Block for Arterio-Venous Fistula Surgeries- Comparison of Two Techniques Using Ultrasound and Ultrasound with Peripheral Nerve Stimulation | International Journal of Regional Anaesthesia | July-December 2022; 3(2): 88-92.

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