Medial vs. Lateral Approach to Ultrasound-Guided Supraclavicular Block: A Prospective Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 78
- 试验地点
- 2
- 主要终点
- Successful block of the Ulnar nerve (C8,T1) fibres. Sensory block with a score of '1' at 30 minutes (loss of sensation to pin prick) is considered successful.
研究概览
简要总结
The ultrasound guided supraclavicular block is a peripheral nerve block which is considered safe, has a fast onset, is dense and provides complete block of the nerves supplying the hand, forearm and arm. However retrospective studies done at Toronto Western Hospital have highlighted the fact that most commonly the ulnar nerve fibres (responsible for sensations in the ring finger, little finger and the corresponding part of hand), sometimes escape this block and need additional supplementary block at a distal peripheral nerve site. It is a confusing fact since all nerve fibres are compactly arranged in a sheath at the supraclavicular level. The local anaesthetic agent at this level should be equally distributed among all nerve fibres. The purpose of this study is to compare two different approaches (medial and lateral) adopted by our clinicians to perform this block and to test the effectiveness of each approach for successful ulnar nerve fibre blockade.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients presenting for upper limb surgery, excluding shoulder surgery
- •Age 18-80 yrs
- •BMI < 35
- •ASA I - III
- •Consent for the study
排除标准
- •Pre-existing sensory or motor neurodeficit.
- •Sensitivity to local anaesthetic agents.
- •Patients on anticoagulants or antiplatelet medications (Minidose Aspirin is acceptable) with abnormal coagulation profile.
- •Compromised pulmonary reserve due to COPD, Kypho-scoliosis or Restricted lung disease.
- •Infection or any obvious pathology at the site of block performance
- •History of drug abuse.
- •Psychiatric disease or any condition that precludes an informed consent.
研究组 & 干预措施
Lateral-to-Medial Approach
Needle approach to the brachial plexus nerves will be made using a lateral-to-medial direction.
干预措施: Lateral-to-Medial Approach (Procedure)
Medial-to-Lateral Approach
Needle approach to the brachial plexus nerves will be made using a lateral-to-medial direction.
干预措施: Media-to-Lateral Approach (Procedure)
结局指标
主要结局
Successful block of the Ulnar nerve (C8,T1) fibres. Sensory block with a score of '1' at 30 minutes (loss of sensation to pin prick) is considered successful.
时间窗: 1 hour prior to surgery
次要结局
未报告次要终点