{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:33:29Z","timestamp":1786649609068,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background and Aims:<\/jats:title>\n There is limited comparative data on sensory-motor block dynamics following single-point drug delivery between ultrasound guided supraclavicular brachial plexus block and costoclavicular brachial plexus block. This study aimed to compare the efficacy of sensory-motor blockade after single-point subfascial injections at these two anatomical locations.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Following institutional ethics approval, 50 patients undergoing upper limb surgery at or below the elbow were randomised to receive a single-point injection of 20 mL of a 1:1 mixture of 2% lignocaine (with 1:200,000 epinephrine) and 0.5% bupivacaine in either the supraclavicular fossa (Gp-SC) or the costoclavicular space (Gp-CC). A blinded observer assessed the sensory-motor function of the musculocutaneous, median, ulnar, and radial nerves by using a 3-point scale. Scores were combined into a total composite score (TCS), assessed every 5 minutes for up to 40 minutes or until a TCS of 0 was achieved. Continuous variables were analysed using an unpaired Student\u2019s\n t<\/jats:italic>\n -test; categorical data were analysed using the Chi-square test.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Gp-CC had significantly lower TCS values than Gp-SC at all intervals except 5 minutes. Complete sensory-motor blockade at 40 minutes was more frequent in Gp-CC (92%) versus Gp-SC (60%,\n P<\/jats:italic>\n < 0.001). Incomplete blockade was largely due to sparing of the ulnar (4% vs 36%,\n P<\/jats:italic>\n = 0.004), median (8% vs 36%,\n P<\/jats:italic>\n = 0.019), and radial nerves (0% vs 20%,\n P<\/jats:italic>\n = 0.025).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n A single-point subfascial injection of local anaesthetic at the costoclavicular space produces a more complete sensory-motor blockade of all four major terminal nerves of the brachial plexus than at the supraclavicular fossa.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_184_25","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:00:34Z","timestamp":1767348034000},"page":"236-243","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of sensory-motor block dynamics after an ultrasound-guided single-point subfascial injection, supraclavicular versus costoclavicular brachial plexus block - A randomised clinical trial"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-7907","authenticated-orcid":false,"given":"T","family":"Sivashanmugam","sequence":"first","affiliation":[{"name":"Professor, Department of Anesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5007-3158","authenticated-orcid":false,"given":"Jaya","family":"Velraj","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anesthesiology, Jawaharlal Institute of Post-graduate Medical Education and Research, Karaikal Campus, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6776-2291","authenticated-orcid":false,"given":"Ramsesh","family":"Manohar","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anaesthesiology, Savitha Medical College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-2095","authenticated-orcid":false,"given":"Manoj K.","family":"Karmakar","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-0305","authenticated-orcid":false,"given":"C Raj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Associate Professor, Mahatma Gandhi Medical Advanced Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Puducherry, 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