Comparison of Costoclavicular Brachial Plexus Block and Supraclavicular Brachial Plexus Block

Comparison of Costoclavicular Brachial Plexus Block and Supraclavicular Brachial Plexus Block

The investigator will compare Costoclavicular approach of infraclavicular block and supraclavicular block. Especially, the incidence of phrenic nerve palsy and the quality of block.

Costoclavicular brachial plexus block is a recently developed approach of infraclavicular brachial plexus block. Using ultrasound, all of 3 cords are well visible in single plane. Compared to conventional infraclavicular block, it needs smaller amount of local anesthetics.

Supraclavicular brachial plexus block is known as spinal anesthesia of upper extremities. It provides fast and good quality of anesthesia and analgesia. But some studies showed that there are over 50% of phrenic nerve palsy in supraclavicular block.

In this study, the investigator will compare phrenic nerve palsy incidence and block quality between Costoclavicular block and supraclavicular block using ultrasound.

Inclusion Criteria:

• ASA I or II
• Scheduled for surgery of hand or forearm

Exclusion Criteria:

• Patient refusal
• Neuromuscular disease
• Pregnancy
• Previous history of surgery of periclavicular region
• Nerve injury history
• Bleeding tendency
• Allergy to local anesthetics
• Other contraindication of regional anesthesia