New Approach to Brachial Plexus Block for Upper Arm Surgery

This study was conducted in western Hospital and research centre Nepalgunj from 2007 to 2010.  It was a prospective non randomized study consisting 250 patient of both sex and aged between 18 and 67 years with ASA (American Society of Anaesthesiologist) grade I and II scheduled for upper arm surgery. The subjects were given brachial plexus block on sitting position with their head tilted to opposite side of the block. In this technique 3 cm long 23 gauge needle was inserted from the point above clavicle to the lateral to subclavian artery pulsation, direction of needle was towards spinous process of 7^th cervical vertebra. This procedure was done in 250 patients. Out of 250 patients 246 patients experienced paresthesia and pain relief after 20 ml solution (mixture of 5 ml 0.5% bupivacaine, 5 ml 2% xylocaine with adrenalin and 10ml normal saline). The onset of sensory block onset was observed to be 6.32±0.94 minutes and duration of sensory block was 2.5 to 4.2 hours. Similarly, the onset of motor block was 10.72±1.0 minutes and duration of action was 0.5 to 2.5 hours.