The effectiveness of ultrasound-guided supraclavicular block for closed reduction of upper extremity injuries in the emergency department

Not Applicable

Completed

• Conditions: pper limb fracture/dislocation; Upper limb fracture/dislocation; Emergency medicine - Other emergency care; Anaesthesiology - Other anaesthesiology

• Registration Number: ACTRN12622001356752
• Lead Sponsor: Metro South Health

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2022-10-21
• Study Completion: 2024-07-12
• Last Update Posted: 5 August 2024

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 78

Inclusion Criteria

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.

Exclusion Criteria

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.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Maximal pain experienced during the closed reduction of the injured part, as reported by the patient on a 10 cm Visual Analogue Scale (VAS) immediately after completion of the procedure, will be the primary outcome measure. The patient will be asked by the treating clinician, nurse or research assistant to mark their pain on a VAS scale printed on paper anchored with no pain” at 0 cm and pain as bad as it could possibly be” at 10 cm[ Immediately after completion of closed reduction of the injured part.]