A Clinical Study Comparing Two Nerve Block Techniques Used for Arm Surgery in Patients with Chronic Kidney Disease

INTERVENTION: Intervention1: Group Sc, Subclavian: All the members of this group will receive ultrasound guided subclavian perivascular injection of local anaesthetic to achieve brachial plexus block using 20ml of 0.5 percent levobupivacaine Intervention2: Group Cc, Costoclavicular: All the members of this group will receive ultrasound guided costoclavicular injection of local anaesthetic to achieve brachial plexus block using 20ml of 0.5 percent levobupivacaine Control Intervention1: NIL: NIL CONDITION: Health Condition 1: N189‐ Chronic kidney disease, unspecified PRIMARY OUTCOME: To measure the time taken to achieve complete conduction blockadeTimepoint: Sensory and motor blockades will be evaluated at 5 minute intervals upto 25 minutes or until a grade 0 is achieved on a 3 point likert scale whichever occurs first SECONDARY OUTCOME: The need for rescue interventionTimepoint: 6hour post operative period. The need for pain alleviation is assessed & appropriate pain management is given if required. Time for first rescue analgesiaTimepoint: 25minutes. At the end of 25minutes if adequate block is not achieved, rescue analgesic is given in the form of supplemental local infiltration, ketamine, propofol infusion, rescue block or general anaesthesia conversion. INCLUSION CRITERIA: All chronic kidney disease patients undergoing forearm surgery