title: The technique comparison of brachial plexus blocks by ultrasound guided with blocks by nerve stimulator guided.
abstract: OBJECTIVE
  Brachial plexus perineural blocks provide specific analgesia for upper limb surgery. We present our experience with ultrasound-guided supraclavicular brachial plexus perineural blocks for distal upper limb surgery. Although single-injection ultrasound-guided supraclavicular blocks have been reported, little is known about the advantages using this approach compared with nerve stimulator guided.
  
  
  METHODS
  There were 60 patients who underwent upper limb surgery for orthopedic trauma and received a supraclavicular brachial plexus anesthesia. 30 patients (U-group) were injected by an ultrasound-guided technique with the needle tip remaining under direct vision. 30 patients (NS-group) were inserted by nerve stimulator guided. Recorded the onset time, puncture times, pains cases with tourniquet in each group. Compared the difference between two groups.
  
  
  RESULTS
  In U-group, all cases had successful perineural injection. Most of them, effect of anesthesia was fast onset and needed insert only once. No pains were reported under using tourniquet. There were no vessel punctures or other direct procedure-related complications. In NS-group, most injections were successful, but slow onset and needed multiply insert needle. 5 patients said pains under using tourniquet when surgery started and had to add opioid by vein. One patients' lung were puncture and result in pneumothorax. One patient's was intravascular injection.
  
  
  CONCLUSIONS
  Supraclavicular brachial plexus perineural insertion using ultrasound guidance is feasible and almost have no complications, deserves further study with a randomized controlled trial comparing this relatively new technique with only using nerve stimulator.
authors.affiliation: The Medical College of Xin Jiang Shihezi University Shihezi 832008, China ; Department of Anestheic, Liaocheng People's Hospital Liaocheng 252000, China.
authors.forename: Guo-Ying
authors.initials: GY
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic, Liaocheng People's Hospital Liaocheng 252000, China.
authors.forename: Zhen-Qiang
authors.initials: ZQ
authors.lastname: Chen
authors.affiliation: Department of Anestheic, Liaocheng People's Hospital Liaocheng 252000, China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Jia
authors.affiliation: The Medical College of Xin Jiang Shihezi University Shihezi 832008, China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Dai
authors.affiliation: Department of Anestheic, Liaocheng People's Hospital Liaocheng 252000, China.
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Zhang
keywords: Peripheral nerve block; nerve stimulator guided; perineural infusion; supraclavicular block; ultrasound-guided supraclavicular block