title: A randomised placebo-controlled trial examining the effect on hand supination after the addition of a suprascapular nerve block to infraclavicular brachial plexus blockade.
abstract: Some 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.
authors.affiliation: University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Flohr-Madsen
authors.affiliation: University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
authors.forename: L M
authors.initials: LM
authors.lastname: Ytrebø
authors.affiliation: University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Valen
authors.affiliation: University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Wilsgaard
authors.affiliation: University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
authors.forename: Ø
authors.initials: Ø
authors.lastname: Klaastad
mesh_terms: D000328:Adult; D000368:Aged; D065527:Brachial Plexus Block / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010919:Placebos; D013484:Supination
chemical_list: D010919:Placebos
keywords: infraclavicular nerve block; peripheral nerves: anatomy; suprascapular nerve block; ultrasound; upper extremity nerve blocks: indications