Comparing Local Anesthetic Techniques for Clavicular Surgeries
- Conditions
- Anesthesia, Local
- Interventions
- Procedure: Clavipectoral fascial plane blockProcedure: Superior trunk block
- Registration Number
- NCT06220591
- Lead Sponsor
- Zagazig University
- Brief Summary
Surgical fixation for acute clavicular fractures is increasingly preferred among orthopedic surgeons to improve healing and decrease the risk of malunion. Regional anesthesia for clavicular fractures allows rapid recovery, prolonged postoperative analgesia, and less opioid consumption, and so decreases the hospital stay. There is no consensus regarding the best regional anesthetic technique for surgical fixation for acute clavicular fractures. Selective supraclavicular nerve block combined with either superior trunk or clavipectoral fascial plane block is a promising regional anesthetic technique for midshaft clavicular surgeries.
- Detailed Description
This study will assess if there is a difference in the quality of surgical anesthesia between selective supraclavicular nerve block combined with either superior trunk or clavipectoral fascial plane block for clavicular fractures. Aiming to achieve high-quality surgical anesthesia and postoperative analgesia for middle clavicular fracture surgeries with optimum hemodynamic stability and high patient and surgeon satisfaction.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 54
- Age: 18-45 years old.
- Sex: both sexes.
- The American Society of Anesthesiologists (ASA) Physical status: ASA I & II.
- Body mass index (BMI): 18.5 - 24.9 kg/m2.
- Type of operations: surgical repair of the midshaft clavicular injuries.
- Patient refusal.
- Known hypersensitivity to lidocaine or bupivacaine.
- Patients with respiratory insufficiency.
- Coagulation disorders or taking drugs affect surgical hemostasis.
- Patients with pre-existing neurological deficits
- Uncooperative patient or with altered mental status.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Clavipectoral fascial plane group Clavipectoral fascial plane block The patient will undergo selective supraclavicular nerve block, then will undergo clavipectoral fascial plane block on the lateral and medial ends of the affected clavicle. Superior trunk group Superior trunk block The patient will undergo selective supraclavicular nerve block, then will undergo block of superior trunk "The fifth \& sixth cervical nerve roots" of the brachial plexus on the side of the affected clavicle.
- Primary Outcome Measures
Name Time Method Time of the first rescue analgesic request by the patient postoperative. 24 hours The patient will be asked to quantify postoperative pain using the visual analogue pain score as the following 0: no pain, and 10: maximum imaginable pain. Nalbuphine 4 mg will be administered intravenous as rescue analgesia if the visual analogue pain score ≥4. The time of the first rescue analgesic request will be recorded.
- Secondary Outcome Measures
Name Time Method Patient and surgeon satisfaction. 24 hours Patient and surgeon satisfaction will be assessed using 7- point Likert-like verbal rating scale.
Any reported complications. 24 hours. The possible side effects will be followed in the first 24 hours postoperative.
Onset of sensory block. 20 minutes From the end of block procedure to the of loss of pin prick sensation will be tested over the affected clavicle.
Ipsilateral diaphragmatic excursion affection. 1 hour Ipsilateral diaphragmatic excursion will be assessed by M-mode ultrasound.
The Numerical Pain Rating Scale in the first 24 hours 24 hours. On a scale of 0-10, the patient will be asked to quantify postoperative pain as the following 0: no pain, and 10: maximum imaginable pain.
The total opioid consumption in the first 24 hours 24 hours. The total dose of intravenous nalbuphine in the first 24 hours postoperatively
Trial Locations
- Locations (1)
Zagazig university hospital
🇪🇬Zagazig, Al-Sharkia, Egypt