• Anaesthesia · Aug 2016

    A randomised placebo-controlled trial examining the effect on hand supination after the addition of a suprascapular nerve block to infraclavicular brachial plexus blockade.

    • S Flohr-Madsen, L M Ytrebø, K Valen, T Wilsgaard, and Ø Klaastad.
    • University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
    • Anaesthesia. 2016 Aug 1; 71 (8): 938-47.

    AbstractSome surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised, placebo-controlled study, our primary outcome measure was the amount of supination (as assessed by wrist angulation) 30 min after infraclavicular brachial plexus block, with (suprascapular group) or without (control group) a supplementary suprascapular block. All blocks were ultrasound-guided. The secondary outcome measure was an assessment by the surgeon of the intra-operative position of the hand. Considering only patients with successful nerve blocks, mean (SD) wrist angulation was lower (33 (27) vs. 61 (44) degrees; p = 0.018) and assessment of the hand position was better (11/11 vs. 6/11 rated as 'good'; p = 0.04) in the suprascapular group. The addition of a suprascapular nerve block to an infraclavicular brachial plexus block can provide a better hand/forearm position for dorsal hand surgery. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

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