Investigators aimed to evaluated accuracy of brachial artery doppler derived indices such as change in pulsatility index, resistive index, and waveform morphology in predicting successful supraclavicular block

supraclavicular brachial plexus block gives adequate anesthesia and analgesia for arm and hand surgeries. successful block was classically evaluated via assessment of both sensory and motor functions, However this carry disadvantages of subjective assessment including patient cooperation. objective monitors of successful block depend on sympasthetic mediated changes including perfusion index, thermography, and LASER doppler.

However most of these tools depend on complicated technology and special devices.

therefore it was assumed that the use of brachial artery derived indices such as pulsatility index, resistive index, and waveform morphology would provide simple, easy and economic assessment tool for successful supraclavicular brachial plexus block

Inclusion Criteria:

- ASA 1 undergoing forearm or hand surgery

Exclusion Criteria:

• patient refusal allergy to local anesthetics fracture humerus Diabetes Melitus peripheral vascular disease

adult patient, ASA 1 and will receive supraclavicular brachial plexus block for forearm or hand surgery