iarjaccIARJACCIARJACC2709-1880https://doi.org/10.47310/iarjacc.2021.v02i02.010Comparison of Usg Guided Technique and Nerve Stimulator Technique in Supraclavicular Brachial Plexus Block in Upper Limb SurgeriesAyeshaRahmanVijaykumarT.KIntroduction: The supraclavicular technique to blocking the brachial plexus is thought to be the simplest and most successful. The traditional method of employing paresthesia to locate the nerve cluster by anatomical landmarks has been linked to a higher failure rate and nerve damage. The peripheral nerve stimulator (PNS) improves brachial plexus localization by locating nerves using a low-intensity electric current (up to 2.5 mA) for a short duration (0.05–1 ms) with an insulated needle to obtain a defined response of muscle twitch or sensation and injecting local anaesthetic solution close to the nerve. However, this method did not minimise the danger of harm to nearby structures. The use of ultrasonography (USG) to locate the brachial plexus has changed the field of regional anaesthesia forever. The expense and knowledge necessary, however, are the limiting elements. The purpose of this research was to compare the two procedures in terms of process time, block properties, and complication rate. Aim and Objective of the Study: The study's goal was to compare USG guided and nerve stimulator techniques for supraclavicular brachial plexus block in upper-limb procedures. Primary Objective: Procedure time, Time of onset of motor and sensory blockade, Duration of blockade. Secondary Objective: Failure rates, Complications (Intra-op and post-op). Subjects: A prospective randomized controlled trial was done on 60 ASA I and II patients who were scheduled for forearm, wrist, and hand procedures. Patients were divided into two groups of 30 each: Group A and Group B. Methods: Inj.2 percent lignocaine with adrenaline 1:200000 and Inj. 0.5 percent bupivacaine were used in both groups. The amount of local anaesthetic administered is determined by body weight and does not exceed the hazardous dose (Inj. Bupivacaine 2mg/kg and Inj. Lignocaine 7mg/kg). The supraclavicular brachial plexus block in Group A was performed using a USG-guided approach, while the block in Group B was performed using a PNS technique. There were both primary and secondary outcomes mentioned. Results: In Group A procedure time was 12.97±2.00 and in group B the procedure time was 22.87±1.52 which is statistically significant (p-value being<0.05). Sensory block onset time was 12.73 1.72 mins (Mean±S.D.) in Group A, while motor block onset time was 21.572.54 mins. In Group B, the time taken for sensory block to be achieved was 17.83±1.70 minutes, and for the motor block was 27.77±1.81 minutes, both of which are statistically significant (p-value 0.05). In Group A the time period for which the sensory action was present was 8.37±0.99 mins (Mean±S.D), whereas in It was 7.13 0.81 in Group B, which is statistically significant (p-value of 0.05). The duration of the motor block in Group A was 6.10 0.80 minutes (Mean S.D.), but it was 6.07 0.74 minutes in Group B, which is statistically insignificant because the "p-value" is 0.08.  Intra-op supplementary medications were not used in group A patients while in group B 6 out of 30 patients received intra-op supplementary medications i.e., Inj. Fentanyl. “p-value” on comparison was 0.009 which was statistically significant. In group A no block failure was observed while in group B 3 blocks out of 30 had failed. “p-value” was 0.07 and was statistically insignificant. There were no adverse effects or post op complications observed in both groups. Conclusion: The ultrasound guided technique is superior to the nerve stimulator technique for administration of supraclavicular brachial plexus block in upper limb surgeries.