ltrasound-guided supraclavicular block versus Bier block for closed reduction of upper extremity injuries in the emergency department: an open-label, non-inferiority, randomised control trial

Metro South Health0 sites78 target enrollmentOctober 21, 2022

Overview

No summary available.

Registry

who.int

Start Date

October 21, 2022

End Date

July 12, 2024

Last Updated

last year

Study Type

Interventional

Sex

All

Sponsor

Metro South Health

•Patients will be eligible for inclusion in the study if they are aged 18 years or above, can provide informed consent, and present to the ED with an upper limb fracture and/or dislocation that requires urgent closed reduction and immobilisation in the ED. Injuries that require closed reduction either as definitive management or as interim management prior to surgical intervention, and are amenable to both BB and UGSCB will be included. These include radius and/or ulnar fractures and/or dislocations, elbow fractures and/or dislocations, and distal humerus fractures.

•Patients will be excluded for the following reasons: local anaesthetic allergy, open fractures, unstable fracture or dislocations that require urgent surgical fixation, pregnancy or anticoagulation. Specific contraindications to UGSCB include chronic lung disease (e.g. COPD or unstable asthma), skin infection over the supraclavicular site of injection and previous surgery or radiation therapy to the supraclavicular region. Specific contraindications to BB include severe hypertension, compartment syndrome, congenital or idiopathic methaemoglobinaemia, sickle cell disease, peripheral vascular disease, peripheral neuropathy, cardiac conduction abnormality and upper limb infection (Kendall et al., 1997\). As patients may be randomised to either UGSCB or BB, they should not have any contraindications to UGSCB and BB. Patients who are screened and excluded will be noted.