Comparative evaluation of performance and block charachterstics of medial versus lateral approach to ultrasound guided Costoclavicular Brachial Plexus block in patients undergoing upper limb surgery

This thesis protocol focuses on comparing the medial versus lateral approaches to ultrasound-guided costoclavicular brachial plexus block in patients undergoing upper limb surgery.

Key Points

Background Brachial plexus blocks are commonly used for upper limb surgeries. The costoclavicular approach offers consistent visualization and reduced complications compared to traditional techniques. However, the medial and lateral approaches to CCB differ in performance ease risk of vascular puncture and block characteristics.

Research Gap Limited studies have directly compared medial and lateral CCB techniques especially regarding onset time performance difficulty and complications.

Aim & Objectives

Primary Compare performance time between medial and lateral approaches.

Secondary Assess needle passes onset of sensorimotor block diaphragmatic excursion block success and complications as vascular puncture pneumothorax.

Methods

Design Randomized controlled trial from October 2025 to March 2027.

Sample Size 54 patients as27 in each group.

Participants Adults aged 18–65 years ASA I/II BMI less than 30 kg/m².

Exclusion Infection at block site allergy to local anaesthetic bleeding disorders.

Groups

Group L Lateral to medial CCB with 20 ml of 0.5% bupivacaine.

Group M Medial to lateral CCB with the same drug.

Outcome Measures Imaging time needling time performance time sensorimotor block scores diaphragmatic excursion complications and patient satisfaction.

Statistical Plan Data analyzed using SPSS v23, with t-tests/ANOVA for continuous data, Chi-square or Fisher’s test for categorical data and p less than 0.05 as significant.

Ethics Institutional Ethical Committee approval obtained. Informed consent will be taken from all participants.

Conclusion of The study aims to clarify whether medial or lateral ultrasound-guided costoclavicular approaches provide better performance and clinical outcomes and helping anaesthesiologists choose the safer and more efficient method for upper limb surgeries.