Effect of ultrasound guided and landmark guided intercostobrachial nerve block on tourniquet pain following axillary brachial plexus block in patients undergoing forearm surgeries A Double blinded randomized controlled trial
试验速览
- 阶段
- 2/3 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 105
- 试验地点
- 1
- 主要终点
- Reduced tourniquet pain and delayed onset of pain during forearm surgeries.
研究概览
简要总结
•The aim of this study is to compare the intensity of tourniquet induced pain between the group A(Ultrasound guided Axillary block),group B(Ultrasound guided axillary block with landmark guided Intercostobrachial nerve block),group C(Ultrasound guided Axillary block with Ultrasound guided Intercostobrachial nerve block) following axillary brachial plexus block in patients undergoing forearm surgeries. And also To compare the onset of tourniquet pain between the study groups and To compare the total analgesics consumption between the study groups
•The axillary block of the brachial plexus is a routine and efficient method for anesthesia of the upper limb during forearm and hand surgery . A tourniquet is used to control bleeding in the surgical field.Application of tourniquet can cause intolerable dull, achy pain in the tissues underneath.Tourniquet pain may have cutaneous and ischemic components.Despite the axillary block , a tourniquet can cause pain that is not tolerable for the patient and disrupts the surgical process, because part of the inner arm is innervated by the intercostobrachial nerve lateral cutaneous branch of the second intercostal nerve (i.e ICBN)
•The intercostobrachial nerve (ICBN) is a pure sensory nerve that arises primarily from the second intercostal nerve (T2).The posterolateral and medial aspect of the arm is supplied by the axillary (AXN) and intercostobrachial nerves (ICBN), which are not anaesthetised by an axillary brachial plexus block (ABPB)
•Blocking the brachial plexus in the axillary area has no side effects (such as pneumothorax, phrenic nerve injury, and recurrent laryngeal nerve injury), as seen with other methods of blocking this plexus, making it the most suitable approach. It seems that in addition to the axillary block of the brachial plexus, this problem can be overcome by blocking the ICBN. Therefore, in the present clinical trial, in addition to axillary block in patients with surgery of the hand and forearm, we also block the ICBN to examine whether the pain caused by a tourniquet during surgery disappears.
•Hence this study is to compare Intercostobrachial nerve (ICBN) block with and without Ultrasound guidance in reducing the intensity of tourniquet induced pain during the axillary block in forearm surgeries.
The use of an ICBN block may associated with reduced tourniquet pain and delayed onset of pain during the procedure. Ultrasound -guided intercostobrachial nerve (ICBN) block may offer greater accuracy and effectiveness compared to the landmark-guided technique
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant and Investigator Blinded
入排标准
- 年龄范围
- 20.00 Year(s) 至 50.00 Year(s)（—）
- 性别
- All
入选标准
- •American society of Anaesthesiologists(ASA) physical status I-II Indication of forearm and hand surgery lasting at least 90minutes Body mass index between 23 and 28.
排除标准
- •History of allergy to local anaesthetics Coagulation problems Upper extremity neuropathy Vasculitis Unstable hemodynamics History of seizures Patient who cannot communicate with investigator.
结局指标
主要结局
Reduced tourniquet pain and delayed onset of pain during forearm surgeries.
时间窗: Intraoperative
Ultrasound -guided intercostobrachial nerve (ICBN) block may offer greater accuracy and
时间窗: Intraoperative
effectiveness compared to the traditional landmark-guided technique.
时间窗: Intraoperative
次要结局
- Consumption of rescue analgesics with the onset of tourniquet pain(Intraoperative)
研究者
Dr Dinesh Naik
S Nijalingappa medical college