A prospective randomized comparison between perivascular and perineural ultrasound guided axillary brachial plexus block for upper limb surgeries

Introduction and Aims: ultrasound had revolutionized the nerve block by, increasing the reliability with less complications. This study evaluates the block characteristics and efficacy between perivascular and perineural ultrasound guided axillary brachial plexus block for upper limb surgeries. Materials and Methods: 100 patients in the age group of 18-60 years belonging to ASA I,II physical status undergoing axillary block in upper limb surgeries were randomly allocated into Group PN- perineural (n=50) and Group PV- perivascular (n=50). In both the groups Musculocutaneous nerve block done with 6ml of local anaesthetic mixture. In perineural group, radial nerve, median nerve and the ulnar nerve were anaesthetized separately with 8ml of local anaesthetic mixture respectively. In perivascular group, the needle tip was then advanced dorsal to the artery, corresponding to 6'o clock position. 24ml of local anaesthetic mixture was incremently injected. The primary objective was to assess the success rate of blockade for surgery. The secondary objectives were to assess the onset and duration of sensory and motor block and to study the incidence of adverse effects. Results: There was no statistical significance in the success rate of blockade between the techniques (PN-98% and PV 96% with P value is 0.362).The sensory and motor onset time in PN group(6.98 min,10.22 min) is faster than PV group(10.96 min,13.50) with P value was<0> Conclusion: we conclude that the USG guided perineural technique as more reliable than the USG guided perivascular technique of axillary block.