Evaluation of anesthesia effectiveness and postoperative pain relief using ultrasound-guided infraclavicular brachial plexus block in upper limb surgery patients at Hai Phong International General Hospital

Abstract

Introduction: Upper limb surgery is very common in trauma cases, and there are many anesthesia methods available for such procedures. Among them, brachial plexus block (BPB) offers several advantages. Many studies suggest that using ultrasound guidance for BPB, in combination with a nerve stimulator, can reduce the amount of local anesthetic required. This approach is considered very safe and widely applicable.Globally, numerous studies have investigated the use of levobupivacaine for BPB at varying concentrations, such as 0.375%, 0.5%, and 0.75%, with different volumes of anesthetic. Therefore, we conducted this study with the aim of evaluating the sensory and motor blockade effectiveness during surgery, as well as postoperative analgesia, of supraclavicular brachial plexus block using 0.5% levobupivacaine at a dose of 2 mg/kg. The procedure was performed under ultrasound guidance in combination with a nerve stimulator in upper limb surgeries. Research method: A study was conducted on 30 patients scheduled for surgical procedures involving the distal two-thirds of the upper arm. All patients received an ultrasound-guided brachial plexus block combined with a nerve stimulator, using 0.5% levobupivacaine at a dose of 2 mg/kg. Parameters assessed included the onset time of sensory and motor blockade, as well as postoperative analgesia. Patient satisfaction and the incidence of adverse effects were also monitored. Results: The onset times for sensory and motor block were 9.31 ± 1.66 minutes and 13.01 ± 1.71 minutes, respectively, allowing surgery to proceed smoothly without the need to convert to general anesthesia. Most patients (93.33%) did not require additional intraoperative analgesia. Postoperative analgesia lasted an average of 11.50 ± 1.55 hours, significantly improving pain management. Notably, no complications or adverse effects related to the technique were reported. Patient satisfaction was very high. Conclusion: Ultrasound-guided supraclavicular brachial plexus block is an effective and safe anesthesia technique for upper limb surgery. It can be considered the preferred anesthetic choice for such procedures, contributing to improved quality of care and patient satisfaction.