{
  "abstract": "Background and Aims The costoclavicular approach to infraclavicular brachial plexus block focuses on the proximal infraclavicular fossa, where the medial, lateral, and posterior cords are closely situated(1). Septa in this region can restrict the spread of local anesthetic with a single injection. This study compared single versus triple aliquot injections for costoclavicular brachial plexus blocks, hypothesizing quicker onset and reduced failure rates with triple injections(2). Primary outcome: block onset time; secondary outcomes: surgical success, postoperative analgesia, and complications.Methods Forty-two patients undergoing upper limb surgery received either single (n=21) or triple (n=21) ultrasound-guided costoclavicular blocks using 30 mL of local anesthetic. In the triple group, the anesthetic was divided and injected near the lateral cord, medial cord, and cord junction. Blockade was assessed every 5 minutes for 30 minutes.Results Triple injections had a faster onset (15.71 ± 4.55 vs. 25.95 ± 3.4 minutes; p < 0.001) but longer performance time (12.05 ± 3.51 vs. 5.52 ± 1.47 minutes; p < 0.001). No differences were found in anesthesia duration, postoperative analgesia, or opioid consumption.Abstract OP47 Figure 1Normal sono-anatomy of the costoclavicular space & triple injection group- needle entry from lateral to medial side (1,2,3- points of triple injections, AA-Axillary artery, AV- Axillary Vein, LC- Lateral Cord, MC- Medial Cord, PC-Posterior Cord)Conclusions The triple injection technique offers a faster onset of anesthesia compared to the single injection method, likely due to improved distribution of the anesthetic around the septa(3). However, the single injection approach is quicker to perform. Both techniques are comparable in terms of anesthesia duration, failure rates, and complications.",
  "authors": [
    {
      "affiliations": [
        "All India Institute of Medical Scieces, New Delhi, New Delhi, India"
      ],
      "name": "Sourav Saha"
    },
    {
      "affiliations": [
        "Professor, All India Institute of Medical Sciences, Delhi, India"
      ],
      "name": "Babita Gupta"
    },
    {
      "affiliations": [
        "Professor, All India Institute of Medical Sciences, Delhi, India"
      ],
      "name": "Abhishek Nagarajappa"
    },
    {
      "affiliations": [
        "Professor, All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Souvik Maitra"
    }
  ],
  "title": "OP47 Comparison of single versus triple injection costoclavicular block in upper limb surgery: randomised controlled trial",
  "uid": "b5905115-8aab-5007-9c19-5c6e130b2312"
}