Ultrasound-Guided Low-Volume Brachial Plexus Block in the Supraclavicular Region for Shoulder Reduction in the Emergency Department: A Retrospective Monocentric Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 206
- 试验地点
- 1
- 主要终点
- Successful shoulder reduction without procedural sedation
研究概览
简要总结
Acute shoulder dislocation is a common and painful condition in the emergency department (ED). Procedural sedation is widely used to facilitate reduction but is associated with potential risks and resource use. Ultrasound-guided regional anesthesia has emerged as an alternative approach.
This retrospective, monocentric observational study analyzes routinely collected clinical data from an orthopedic ED between February 2018 and February 2024. Adult patients with acute shoulder dislocation are included.
The study evaluates the feasibility, safety, and clinical implementation of low-volume (approximately 5 ml local anesthetic) ultrasound-guided brachial plexus block in the supraclavicular region. Outcomes include procedural success, block-related complications, and temporal trends reflecting the adoption of the technique over time.
详细描述
Acute shoulder dislocation is a frequent orthopedic emergency requiring timely reduction. Procedural sedation and analgesia (PSA) is commonly used but may be associated with risks and increased resource utilization. Ultrasound-guided regional anesthesia of the brachial plexus represents an alternative approach that may allow effective reduction without systemic sedation.
This retrospective, monocentric observational study is based on routinely collected clinical data from the orthopedic emergency department of the Merian Iselin Klinik Basel, Switzerland, covering the period from February 2018 to February 2024. All eligible patients with acute shoulder dislocation were included.
During the study period, ultrasound-guided low-volume brachial plexus block in the supraclavicular region was progressively implemented as part of routine clinical practice. The technique used a standardized low-volume approach (approximately 5 ml local anesthetic).
The aim of this study is to evaluate the feasibility and safety of this approach in a real-world setting, as well as to describe its implementation over time. Particular focus is placed on procedural success, block-related complications, and temporal trends reflecting increasing use and operator experience.
The study further explores the practical aspects of integrating this technique into routine emergency care, including its applicability across a broader group of physicians in a setting with rotating staff and limited case numbers.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 15 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients presenting with acute shoulder dislocation to the orthopedic emergency department of the Merian Iselin Klinik Basel between February 2018 and February
- •Patients treated within routine clinical care with documented management of shoulder reduction.
排除标准
- •Patients with incomplete or missing clinical documentation relevant to the study endpoints.
研究组 & 干预措施
Patients with acute shoulder dislocation
Adult patients presenting with acute shoulder dislocation to the orthopedic emergency department between February 2018 and February 2024. Patients were treated according to routine clinical practice, including ultrasound-guided low-volume brachial plexus block or alternative approaches.
干预措施: Ultrasound-guided brachial plexus block (Procedure)
结局指标
主要结局
Successful shoulder reduction without procedural sedation
时间窗: During the emergency department visit
Proportion of patients in whom shoulder reduction was successfully achieved using ultrasound-guided low-volume brachial plexus block without conversion to procedural sedation or general anesthesia.
次要结局
- Block-related complications(During the emergency department visit)
- Conversion to procedural sedation(During the emergency department visit)
- Temporal trends in technique utilization(February 2018 to February 2024)