Single Versus Multiple Injections for Axillary Plexus Block
- Conditions
- Upper Extremity
- Interventions
- Drug: Multiple injection local anestheticDrug: Single injection local anesthetic
- Registration Number
- NCT03378323
- Lead Sponsor
- Hôpital du Valais
- Brief Summary
Patients will be randomized to one of two groups:
1. Multiple injection group: Axillary brachial plexus block with multiple injections, with the arm abducted, performed with the aid of ultrasound;
2. Single injection group: Axillary brachial plexus block with a single injection, with the arm placed behind the head and the elbow flexed, performed with the aid of ultrasound
- Detailed Description
The study will be proposed to all patients undergoing formarm or hand surgery under axillary brachial plexus block. Patients will be randomized to one of two groups The first group - multiple injection group - will receive an ultrasound-guided axillary brachial plexus block with the traditional technique, i.e. multiple injections of local anesthetic in proximity to the 4 nerfs that innervate the arm. The arm will be abducted during the block procedure.
The second group - single injection group - will receive an ultrasound-guided axillary brachial plexus block with the arm placed behind the head and the elbow flexed. In this position the different nerfs group around the axillary artery where they will be blocked with a single injection of local anesthetic.
All patients will receive the same type and amount of local anesthetic: 30 ml of a mixture of ropivacaine 0.5 % + mepivacaine 1 %.
The primary outcome measure is the time needed for the performance of the block. Secondary outcomes are: success rate of the block at 30 minutes after the injection, needling time, time to first analgesic request, postoperative opioid consumption, pain scores at 12 and 24 hours postoperatively, block-related complications, and patient satisfaction. These outcomes are further defined in the section below.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 50
- Adult patients who undergo forearm or hand surgery under axillary brachial plexus block
- History of allergic reaction to local anaesthetics
- Peripheral neuropathy
- Renal or hepatic insufficiency
- Coagulation disorders
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Multiple injection local anesthetic Multiple injection local anesthetic Ultrasound guided axillary plexus block with multiple injections of local anesthetic Single injection local anesthetic Single injection local anesthetic Ultrasound guided axillary plexus block with a single injection of local anesthetic
- Primary Outcome Measures
Name Time Method Performance time 10 minutes Time in minutes from ultrasound probe placement to end of local anesthetic injection
- Secondary Outcome Measures
Name Time Method Time to first analgesic request 24 hours Time in minutes to first analgesic request postoperatively
Block-related complications 24 hours Infection, bleeding, neurological problems, pain during the 24 postoperative hours
Pain scores at 12 hours postoperatively 12 hours Measured on a visual analogue scale between 0 and 10 (0 = no pain, 10 = worst pain imaginable)
Needling time 15 minutes Time in seconds to complete the block
Patient satisfaction 24 hours Assessed by numerical rating scale on a scale between 0 (= completely dissatisfied) and 10 (= completely satisfied)
Pain scores on postoperative day 1 24 hours Measured on a visual analogue scale between 0 and 10 (0 = no pain, 10 = worst pain imaginable)
Postoperative opioid consumption on postoperative day 1 24 hours intravenous morphine equivalent consumption during the 24 postoperative hours
Trial Locations
- Locations (1)
Hopital du Valais
🇨🇭Sion, Switzerland