Comparative efficacy of ultrasound guided supraclavicular block versus combined infraclavicular block and suprascapular block in patients undergoing upper limb surgery under general anaesthesia: A Randomised Controlled Trial

Post operative analgesia results in patient comfort and satisfaction, early ambulation, reduced respiratory and cardiovascular complications, reduced risk of deep vein thrombosis, early recovery and low health care expenditure for patient and for the hospital.

The Supraclavicular block is advantageous as the brachial plexus are highly packed in this approach and speed of onset is often rapidly achieved. The supraclavicular block is given ion the supraclavicular fossa in transverse orientation parallel to the clavicle and aimed inferior toward the ipsilateral thorax. It is suggested to provide effective anaesthesia for shoulder surgeries, proximal humerus  and upper limb surgeries upto the fingertips.

The Infraclavicular block is regional anaesthesia technique that blocks the cords of the brachial plexus below the clavicle. The disadvantages of the infraclavicular block is that it spares the shoulder nerves leading to pain during peri operative positioning and post operative pain of the shoulder. Suprascapular nerve provides 70% sensory fibres of the shoulder joint, capsule and overlying skin and also supplies motor branches to the supraspinatus and infraspinatus muscle, therefore providing excellent pain relief in the shoulder joint. The combination use of infraclavicular block and suprascapular nerve block has been successfully used as ab analgesia for proximal humerus surgeries, shoulder surgeries and infraclavicular block covering for upper extremity surgeries such as elbow, forearm and hand.