Ultrasound Guided Brachial Plexus Block in Upper Extremity Surgeries: Experiences from a Tertiary Care Hospital of Bangladesh

Brachial plexus block has been gained popularity after its introduction because of provision of quality anesthesia and optimal postoperative analgesia in upper arm surgeries, and introduction of ultrasound guidance in recent years further enhances the practice because of efficacy and safety of procedure. This retrospective observational study evaluated the outcome and safety of ultrasound-guided brachial plexus block (supraclavicular and interscalene approach) in a tertiary care hospital of Bangladesh over 3-years period (January 2017 to December 2019) through analyzing preoperative anesthesia evaluation form, anesthesia documents and postoperative records. 113 patients were covered during the study period, of which 59 (52.2%) were males and 54 (47.8%) were females. Mean age of the patients were 38.94 {+/-} 20.37 years. Majority of the patients (63.7%) were in ASA grading I. Operative time for surgeries were 115.30 {+/-} 35.19 minutes. duration of sensory and motor block were 618 {+/-} 55 minutes and 450 {+/-} 74 minutes respectively. And first dose of postoperative analgesic was given after 705 {+/-} 94 minutes of surgery. Tachycardia and hypertension were observed in 4.4% patients, where failure of motor blockade and puncture of subclavian vein were recoreded 1.8% and 0.9% respectively. Current study found that with ultrasound guidance in skilled hands, brachial plexus blockade through combination of supraclavicular and interscalene approaches can provide quality anesthesia and analgesia with minimal complications.