الفهرس 
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Abstract
Supraclavicular approach had significantly better needle visualization scores than retroclavicular approach.
• Patients subjected to supraclavicular block had significantly better score for number of attempts and visualization of needle than those subjected to retroclavicular block.
• Needling time was significantly shorter in patients subjected to supraclavicular block compared to those subjected to retroclavicular block.
• Patients subjected to supraclavicular block had significantly higher mean sensory loss score from 10, 15 and 20 mins post- procedure in different nerves represented in (Radial, Median, Ulnar, Musculo-cutaneous and Medial cutaneous nerves) compared to those subjected to retroclavicular block.
• Patients subjected to supraclavicular block had significantly higher mean sensory loss score from 10-, 15- and 20-mins post- procedure in different nerves represented in (Radial, Median, Ulnar, Musculo-cutaneous and Medial cutaneous nerves) compared to those subjected to retroclavicular block.
• Duration of sensory and motor blocks which were comparable between patients subjected to supraclavicular block and those subjected to retroclavicular.
• Brachial plexus block via supra and retro clavicular approaches, success rate was comparable.
• The occurrence of complications was insignificantly different between patients subjected to brachial plexus block via supra and retro clavicular approaches.
• Time of surgical procedure performed in the studied patients was comparable between patients subjected to supra or retro clavicular blocks.
Conclusion
For the ultrasound-guided approach to the brachial plexus, the supraclavicular approach had significantly better block related outcomes including needle visualization scores, shorter needling time, higher mean sensory loss score, and higher mean motor loss score than retro clavicular approach.
Retroclavicular approach has a longer duration in blocking both sensory and motor stimuli.
Limitations
● It was a single centric study.
● The sample size was relatively small.
● The study did not compare the results to the traditional infraclavicular brachial plexus block.
● Nerve stimulation technique was not used or echogenic needle was used.
Recommendation
• Supraclavicular technique should be used when operation is urgent as it’s less time consuming while Retroclavicular approach is advisable in long time operations as it has longer sensory duration block than supraclavicular technique.
● Further prospective studies with larger sample size are needed in order to evaluate the supraclavicular approach in the brachial plexus block.
● Supraclavicular approach could be a valuable regional anesthetic in brachial plexus block.