{
  "abstract": "Background and Aims The intertruncal approach of the supraclavicular block offers better block dynamics and faster onset of surgical anaesthesia and success rate comparable to other approaches like corner pocket approach. However, there are no studies comparing the two techniques of intertruncal approach (double-injection technique vs triple-injection technique). Our study aimed to assess the efficacy of the ultrasound guided double versus triple-injection techniques of intertruncal approach of supraclavicular block by comparing the proportion of patients with complete sensory blockade at 20 minutes. Secondary objectives include procedure time, NRS scores, patient satisfaction scores, onset time, diaphragmatic excursion and adverse events.Methods Following ethics committee approval and with a non-inferiority margin of 20%, 94 ASA I- III(aged 18 - 75 years), undergoing upper limb surgeries were randomised into two groups: double-injection group(DI, n=47) and triple-injection group (TI, n=47). Both groups received 25 ml of 0.5% bupivacaine. In DI group, 10 ml of LA was administered between the lower and the middle trunks and 15 ml of LA between middle and upper trunks. In TI group, 10 ml of LA was injected between the lower and middle trunks, 7.5 ml of LA between middle and the upper trunks and 7.5 ml of LA between upper trunk and pre-vertebral fascia. Brachial plexus block assessment and diaphragmatic excursion were recorded.Results Both groups achieved comparable rates of complete sensory block at 20 minutes. The TI group showed significantly higher rates of complete motor and composite block at 25 minutes, with a faster onset. Procedure time, NRS scores, and patient satisfaction were similar between groups. Incidence of partial hemidiaphragmatic paresis was comparable, with no cases of complete paralysis in either group.Conclusions The double injection technique of intertruncal supraclavicular block is non-inferior to the triple injection technique of the same approachAbstract EP094 Figure 1Ultrasound image showing needle tip between middle and lower trunkAbstract EP094 Figure 2Ultrasound image showing needle tip between upper and middle trunk (drug injected)Abstract EP094 Figure 3Ultrasound image after needle pierced the pre-vertebral fascia and upper trunk",
  "authors": [
    {
      "affiliations": [
        "Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Sriraam Swaminathan"
    },
    {
      "affiliations": [
        "Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Debesh Bhoi"
    },
    {
      "affiliations": [
        "Anaesthesiology, Yashodha hospitals, Ghaziabad, New Delhi, India"
      ],
      "name": "Lokesh Kashyap"
    },
    {
      "affiliations": [
        "Anaesthesiology, ESIC hospital, Faridabad, New Delhi, India"
      ],
      "name": "Virendar Kumar Mohan"
    },
    {
      "affiliations": [
        "Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Anjolie Chhabra"
    },
    {
      "affiliations": [
        "Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Ravindra Kumar Pandey"
    },
    {
      "affiliations": [
        "Anaesthesiology, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Bikash Ranjan Ray"
    },
    {
      "affiliations": [
        "Orthopaedics, All India Institute of Medical Sciences, New Delhi, New Delhi, India"
      ],
      "name": "Mohammad Tahir Ansari"
    }
  ],
  "title": "EP094 Comparison of ultrasound guided double-injection vs triple-injection technique of intertruncal approach of supraclavicular brachial plexus block: a randomised non-inferiority trial",
  "uid": "3a502362-b402-553c-9b3e-4a88ce0029fd"
}