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Retroclavicular Versus Costoclavicular Approach for Infraclavicular Brachial Plexus Block

Not Applicable
Completed
Conditions
Disorder of Upper Extremity
Registration Number
NCT03190551
Lead Sponsor
Antalya Training and Research Hospital
Brief Summary

The primary aim of this study is to compare needle shaft visibility between the retroclavicular approach and costoclavicular approach for infraclavicular brachial plexus block in patients undergoing elective upper limb surgery. Secondary aim is to investigate the differences between the two groups in sensorial block success rate, block performance time, block performance related pain, motor block success rate, surgical success rate, complications, patient satisfaction, use of supplemental local anesthetic, use of analgesic.

Detailed Description

Infraclavicular blocks are performed with different approaches. This study evaluated the effectiveness, safety and feasibility of a retroclavicular brachial plexus block as compared with costoclavicular approach for infraclavicular brachial plexus block. 60 patients scheduled for elective upper limb surgery were recruited and randomized into two groups: Retroclavicular approach for infraclavicular block (Group I), costoclavicular approach for infraclavicular block (Group R). Sensory block, adverse effects and complications were evaluated and recorded every 5 minutes until 30 min after local anesthetic injection. Success rate of each nerve sensory block, complications, rate of satisfaction, rate of failure and incidence rate of adverse effects, the needle shaft visibility, procedure time,duration of the block's effect, use of supplemental local anesthetic, use of analgesic are compared with both groups.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • patients who undergo elective forearm or hand surgery under infraclavicular brachial plexus block
  • American Society of Anesthesiologists class 1 to 3
  • Ability to consent
Exclusion Criteria
  • History of allergic reaction to local anaesthetics
  • Peripheral neuropathy
  • Renal or hepatic insufficiency
  • Coagulation disorders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Needle shaft visibility10 minutes after the needle inserted the skin

Needle visibility reviewed by two anesthesiologists using a 5-point Likert scale

Secondary Outcome Measures
NameTimeMethod
Patient satisfaction using a visual analogue scaleAssessed 24 hours after the block

Using a visual analog scala, patients will quantify their satisfaction with the retroclavicular and costaclavicular technique .

motor block success rateAssessed 40 minutes after block completion

Success is defined as complete motor block in the distribution of the radial, median, ulnar, musculocutaneous nerves of the forearm and hand

complications such as pneumothorax, hemothorax, intraarterial injection, intravenous injection24 hours

Asked about possible complications

Success Rate of the sensorial BlockAssessed 30 minutes after block completion

Success is defined as complete sensory loss in the distribution of the radial, median, ulnar, musculocutaneous, and medial cutaneous nerves of the forearm and hand

Technique durationTime required in seconds for the block completion (10 minutes)

Number of seconds needed to complete the block, from time of local skin anesthesia until regional block needle removal.

supplemental analgesic used90 minutes after block completion

The use of supplementary local anesthetic and the use of intravenous narcotics were recorded.

Block performance related pain10 minutes after the needle inserted the skin

Block performance related pain was evaluated with a visual analog scala after the removal of the needle.

Trial Locations

Locations (1)

Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation

🇹🇷

Antalya, Turkey

Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation
🇹🇷Antalya, Turkey

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