PECS II Versus ICBN Block Plus SCNB for AV Fistula Creation in CRF Patients

Phase 1

Completed

• Conditions: Postoperative Pain; Intraoperative Analgesia
• Interventions: Other: ultrasUltrasound-guided Intercostobrachial nerve block supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 m; Other: ultrasound-guided pectoral nerves block type II supplemental to supraclavicular block

• Registration Number: NCT04988776
• Lead Sponsor: Menoufia University

Brief Summary

Brachial plexus block (BPB) is often utilized for proximal arm arteriovenous access creation. However, the medial upper arm and axilla are often inadequately anesthetized, as the Intercostobrachial nerve (which provides sensory supply to the axilla, upper medial arm, and a small area at the upper lateral chest) is not a component of the brachial plexus. This requires repeated, an intraoperative local anesthetic (LA) supplementation up to conversion into GA. The intercostobrachial nerve (ICBN) is a purely sensory nerve that arises primarily from the second intercostal nerve (T2) with occasional contribution from T3. Therefore, It is not a component of the brachial plexus and is not anesthetized by brachial plexus blockade. The ICBN can be blocked together with other nerves, such as the pectoral, intercostal, and long thoracic nerves in a recently described technique named pectoral nerves block type II (PECS II ).In this thesis, investigators compared the use of the PECS II block and ICBN block as a supplement to supraclavicular brachial plexus block for providing complete anesthesia of the upper arm for fistula creation surgery.

Detailed Description

Not available

Study Timeline

• Study Start: 2020-02-01
• Primary Completion: 2021-02-28
• Study Completion: 2021-02-28
• Study First Submitted: 2021-07-25
• Study First Submitted QC: 2021-07-25
• Study First Posted: 2021-08-03
• Status Verified: 2021-09
• Last Update Submitted: 2021-09-17
• Last Update Posted: 2021-09-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• ESRD patients.
• Proximal Arm Arteriovenous Access Surgery.
• Elective or emergency surgery
• American Society of Anesthesiology (ASA) physical status II to III.

Exclusion Criteria

• Inability of the patient to provide informed consent, communicate or cooperate
• History of allergy to local anesthetics.
• Preexisting upper limb neurological disease at the side of the surgery.
• Patients on anticoagulant therapy or with history of coagulopathy.
• Previous surgery at or near the site of the study.
• The presence of skin infection at the puncture site.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
group A	ultrasUltrasound-guided Intercostobrachial nerve block supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 m	Patients received ultrasound-guided Intercostobrachial nerve block with 10 ml 0.25% bupivacaine (5 ml 0.5% bupivacaine will be added to 5ml 0.9% normal saline ) supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 ml of 0.9 %Nacl ) .
group B	ultrasound-guided pectoral nerves block type II supplemental to supraclavicular block	patients received ultrasound-guided pectoral nerves block type II with 10 ml 0.25% bupivacaine (5 ml 0.5% bupivacaine will be added to 5ml 0.9% normal saline ) supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 ml of 0.9 %Nacl )

Primary Outcome Measures

Name	Time	Method
intraoperative local anesthetic requirement	1-2 hours after surgery start	volume of local anesthetic

Secondary Outcome Measures

Name	Time	Method
postoperative pain	24 hours after end of surgery	Visual analogue score (0-10) where 0=no pain and 10=the worst pain

Trial Locations

Locations (1)

Ashraf Magdy Eskandr; 🇪🇬 Shibīn Al Kawm, Menoufia, Egypt