An observational study of ultrasound guided infraclavicular brachial plexus block with Costoclavicular and Retroclavicular approaches for upperlimb orthopedic surgeries
试验速览
- 阶段
- 3 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- 1) Block performance time.
研究概览
简要总结
Most upper limb surgeries are done under brachial plexus block as it provides anesthesia along with postoperative analgesia without any need of airway manipulation.
According to site of injury and other factors Brachial plexus block is given through various approaches like Interscalene block, Supraclavicular, Infraclavicular or Axillary .Infraclavicular block provides excellent anesthesia for upper limb surgeries.
The infraclavicular brachial plexus has easily recognisable sonoanatomy, a high success rate, and low risk of pnemothorax. Identification of the axillary artery is the key landmark in performing this block.The use of ultrasound (USG) adds valuable information such as visualisation of the needle tip and real-time observation of the injectate surrounding the nerves. Use of USG also reduces the risk of adverse events such as inadvertent intravascular injection and trauma to surrounding structures.
In the costoclavicular approach, the ultrasound transducer is placed parallel to and below the clavicle. In this view, the cords are clustered together, at a more superficial level,the cords could be blocked more rapidly with the CC approach and that the block is administered faster and requires a fewer number of needle redirections. There is no increased incidence of pneumothorax with the CC approach.
The Retroclavicular approach consists of inserting the needle in the supraclavicular fossa, behind the clavicle, in-plane in a paramedian sagittal plane cephalo-caudad direction until the needle tip is positioned behind the axillary artery with the US probe resting in the delto-pectoral groove.The point of needle insertion, however, is over the trapezius muscle posteriorly. This approach allows the needle to pass between the scapula and the clavicle toward the axillary artery in the infraclavicular area.
These two techniques are simple, reliable ,safe and effective.In our institute so far no study evaluating the characteristics of these two techniques is done. Hence, we are planning to do this study.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 盲法
- None
入排标准
- 年龄范围
- 18.00 Year(s) 至 65.00 Year(s)（—）
- 性别
- All
入选标准
- •Patients who will undergo planned upper limb surgeries under usg guided Infraclavicular brachial plexus block with Costoclavicular and Retroclavicular approaches and giving written informed consent.
- •Patients belonging to ASA class 1, 2,3 .
- •3.Patients of either sex, in the age group of 18 to 65yrs.
排除标准
- •Patients with known hypersensitivity to local anaesthetics.
- •Infection at the site of block .
- •Morbidly obese patient.
- •4.Patients with neurological, psychiatric or neurovascular disorders.
- •5.Patients with major cardio-pulmonary or hepato renal compromise.
- •Pregnant patients.
结局指标
主要结局
1) Block performance time.
时间窗: 1) Block performance time will be assessed from time of needle insertion to time of injecting drug | 2) Block characteristics- onset and duration of sensory and motor block for 24 hours | 3)Quality of block.
2) Block characteristics- onset and duration of sensory and motor block
时间窗: 1) Block performance time will be assessed from time of needle insertion to time of injecting drug | 2) Block characteristics- onset and duration of sensory and motor block for 24 hours | 3)Quality of block.
3)Quality of block.
时间窗: 1) Block performance time will be assessed from time of needle insertion to time of injecting drug | 2) Block characteristics- onset and duration of sensory and motor block for 24 hours | 3)Quality of block.
次要结局
- 1)Duration of post operative analgesia and requirement of analgesics in 24 hours.(2)Intraoperative Hemodynamic changes.)
研究者
Dr Dhrumi Sutariya
New civil hospital surat