The Comparation of Lateral Sagittal Infraclavicular and Costoclavicular Block

Not Applicable

• Conditions: Upper Extremity Problem
• Interventions: Procedure: lateral sagittal infraclavicular block; Procedure: costoclavicular brachial plexus block

• Registration Number: NCT04921852
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

In this study, the investigators aimed to compare the block dynamics and characteristics of the two approaches while providing effective analgesia and safe anesthesia of the Ultrasound-guided Lateral sagittal Infraclavicular and costoclavicular approach in Brachial plexus blocks.

Detailed Description

Participants between the ages of 18-70 with the American Society of Anesthesiology (ASA) score I-II-III will be included in the study. All participants will be evaluated preoperatively and information will be given about the anesthetic method to be applied. Demographic data and ASA scores of the participants will be recorded.

All of the participants included in the study will be taken to the regional anesthesia application room in the operating room approximately 1 hour before the operation. After standard anesthesia monitoring (electrocardiography, pulsoximetry, non-invasive blood pressure), all participants will be given an iv vascular access with a 20 or 22 G cannula from the arm that will not be operated.

All blocks will be made using portable US machine and echogenic block needle.

For all blocks, 20 ml of a mixture of 0.25% bupivacaine, 1% lidocaine will be used.

An overall (average) sensory and motor score was also calculated for every participants and at each time point assessed by averaging the VRS sensory or motor scores of all the 4 nerves will be tested preoperatively.

Study Timeline

• Study First Submitted: 2021-05-30
• Status Verified: 2021-06
• Study First Submitted QC: 2021-06-04
• Last Update Submitted: 2021-06-04
• Study Start: 2021-06-07
• Study First Posted: 2021-06-10
• Last Update Posted: 2021-06-10
• Primary Completion: 2021-09-07
• Study Completion: 2021-10-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 46

Inclusion Criteria

• American Society of Anesthesiologists physical status 1 to 3
• 18-70 age
• hand , wrist , forearm and elbow surgery

Exclusion Criteria

• refusal to participate,
• pregnancy,
• body mass index of 30 kg/m2 or greater
• history of allergy to local anesthetic drugs
• prior surgery over the infraclavicular fossa,
• preexisting neurological deficit
• coagulopathy
• infection over infraclavicular fossa.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
lateral sagittal group	lateral sagittal infraclavicular block	-
costoclavicular group	costoclavicular brachial plexus block	-

Primary Outcome Measures

Name	Time	Method
readiness for surgery time	30 minute	Sensory block, defined as a loss of sensation to cold (ice), in the cutaneous distribution of the median (MN), radial (RN), ulnar (UN), and musculocutaneous (MCN) nerves will be assessed and graded according to a VRS (0-100, 100 = normal sensation and 0 = no sensation). Motor blockade of each of the 4 nerves in the ipsilateral upper extremity was also assessed and graded according to a 3-point qualitative scale (2 = normal motor power, 1 = paresis, and 0 = paralysis).Onset of sensory and motor blockade for each nerve was defined as the time (onset time) it took to achieve a sensory VRS of 30 or less and motor power grade of 1 or less, respectively.Time to readiness for surgery was defined as the time it took to achieve an overall sensory score of 30 or less and motor power grade of 1 or less, in all the 4 nerves tested.

Secondary Outcome Measures

Name	Time	Method
block performance time	5 minute	the time it took from the start of the local skin infiltration to the end of the local anesthetic injection