Comparative Study of Supraclavicular Block and Bier's Block in Forearm Surgery in Trauma Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 66
- 试验地点
- 1
- 主要终点
- 1)onset of sensory block 2)degree of motor blockade
研究概览
简要总结
This study compared two common anesthesia techniques used for forearm trauma surgery-Bier's block and the supraclavicular block-to determine which provides better surgical conditions and patient comfort. Among the 66 patients studied, Bier's block produced a much faster onset of numbness and muscle relaxation, but its pain relief wore off quickly. In contrast, the supraclavicular block took longer to take effect but provided significantly longer-lasting postoperative pain relief and greater overall patient comfort, making it more suitable for trauma cases where prolonged anesthesia and smoother recovery are needed. Overall, the study found the supraclavicular block to be the more effective and patient-friendly option for forearm surgeries.
详细描述
Forearm trauma surgery commonly requires regional anesthesia to provide surgical conditions and postoperative pain relief. Two widely used techniques are Bier's block (intravenous regional anesthesia) and the supraclavicular brachial plexus block, but limited evidence exists comparing their performance specifically in trauma patients. This randomized controlled trial evaluates these two approaches to determine differences in onset of sensory and motor block, duration of postoperative analgesia, and patient comfort. Bier's block is known for its simplicity and rapid onset but is limited by tourniquet pain and a short duration of analgesia once the tourniquet is released. In contrast, the supraclavicular block provides dense anesthesia of the upper limb with the potential for longer postoperative pain relief, especially when performed under ultrasound guidance. In this study, 66 adult patients undergoing forearm surgery were randomized to receive either Bier's block or supraclavicular block using standardized techniques. An independent observer assessed block onset and recovery characteristics, and patient comfort was recorded using validated scales. The goal of this study is to generate evidence that may guide anesthetic selection for forearm trauma cases by identifying which block technique offers better perioperative performance and enhances postoperative pain control while avoiding unnecessary duplication of data reported in other fields of the trial record.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
盲法说明
An independent outcomes assessor was blinded to group allocation. This assessor was not involved in administering the anesthesia and had no knowledge of whether the participant received a Bier's block or a Supraclavicular block. Sensory block onset, motor block onset, and patient comfort scores were evaluated by this blinded assessor to minimize assessment bias. No other study personnel were masked due to the distinct nature of the two anesthesia techniques.
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged 18 to 60 years
- •ASA physical status I-III
- •Patients scheduled for elective or emergency forearm surgery
- •Presence of forearm fracture or upper limb trauma requiring regional anesthesia
- •Ability to provide informed consent
排除标准
- •Patient refusal or inability to give informed consent
- •Known allergy to local anesthetic agents
- •Coagulopathy or bleeding disorders
- •Infection at the block site
- •Pre-existing neurological deficits in the affected limb
- •Severe cardiac, hepatic, or renal disease
- •History of seizure disorders
- •Pregnancy
- •ASA physical status IV or higher
- •Inability to cooperate with block assessment
研究组 & 干预措施
Bier's Block (IVRA)
Participants assigned to this arm received a Bier's block (Intravenous Regional Anesthesia). After IV access was established distally in the operative limb, the limb was exsanguinated using an Esmarch bandage and a double pneumatic tourniquet was applied. The proximal cuff was inflated 50-100 mmHg above systolic pressure, followed by IV administration of 30 mL of 0.5% lidocaine. The distal cuff was inflated after 20-30 minutes or upon tourniquet discomfort. This technique provided regional anesthesia for forearm surgery.
干预措施: Bier's Block (IVRA) (Procedure)
Supraclavicular Block
Participants received an ultrasound-guided supraclavicular brachial plexus block. After premedication with midazolam (1 mg) and nalbuphine (0.1 mg/kg), a 30 mL local anesthetic dose was injected using a two-point needle technique under real-time ultrasound visualization. A single tourniquet was applied at 100 mmHg above systolic pressure after block establishment. This technique provided anesthesia for forearm trauma surgery.
干预措施: Supraclavicular Block (Procedure)
结局指标
主要结局
1)onset of sensory block 2)degree of motor blockade
时间窗: 6 months
ONSET OF SENSORY BLOCK It is the period of time between the local anesthesia injection and the loss of pinprick sensation. 0=feeling sharp pinprick (no block) 1. blunt sensation on pinprick (partial block) 2. no sensation on pinprick (complete block). DEGREE OF MOTOR BLOCKADE Motor blockade was assessed by modified Bromage scale 0 = normal muscle function with full range of movement of elbow, wrist and fingers 1 = decreased muscle power so that patient can move fingers and /or wrist only 2 = complete loss of muscle function with movement in fingers/wrist
次要结局
- 3)duration of analgesia(6 months)
研究者
Abira Rashid
postgraduation resident
Sargodha Medical College