ULTRASOUND GUIDED SUPRACLAVICULAR AND INFRACLAVICULAR BLOCKS FOR HAND AND FOREARM SURGERIES: A COMPARISON
- Conditions
- Other specified injuries of wrist,hand and finger(s), (2) ICD-10 Condition: S52||Fracture of forearm,
- Registration Number
- CTRI/2023/07/055701
- Lead Sponsor
- Silchar medical college and hospital
- Brief Summary
Regional nerve block is a technique used to provide anesthesia for upper extremities surgeries, such as arm, forearm, and hand. It reduces the adverse effects of anesthetic drugs during general anesthesia and laryngoscopic stress response. Techniques for correct placement include eliciting paresthesia, peripheral nerve stimulator, and ultrasound guidance. A well-conducted regional anesthetic technique offers advantages over general anesthesia, such as maintaining awareness, avoiding polypharmacy, better hemodynamic stability, and excellent post-operative analgesia.
Supraclavicular and infraclavicular blocks are popular techniques for upper limb surgeries, with the supraclavicular brachial plexus block being a popular choice due to its quick onset and high success rate. However, it has higher complications like inadvertent vascular injections, pneumothorax, phrenic nerve palsy, and Horner’s syndrome.
Ultrasonography has rekindled interest in infraclavicular blocks, targeting the branches of the brachial plexus that innervate the arm, forearm, and hand. Infraclavicular blocks have fewer complications with ultrasound, are less invasive, and have a lower risk of complications. However, the plexus is deeper and the angle of approach is more acute, making synchronized visualization challenging for inexperienced hands and obese patients.
Although both supraclavicular and infraclavicular blocks can be used for upper limb surgeries, anesthesiologists often prefer supraclavicular over infraclavicular blocks due to technical difficulties and increased complications. Understanding the brachial plexus’s anatomy is essential for proper localization during regional anesthesia techniques. Ultrasonography has made it a valuable adjunct in peripheral nerve blocks, offering advantages such as direct visualization of nerves and surrounding anatomy, continuous monitoring of needle tip and drug spread, and predicted speedier and safer infraclavicular blocks with ultrasound guidance.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 120
- ASA grade 1 or 2.
- Elective hand and forearm surgeries.
- Patients of either sex aged eighteen to sixty years.
- Total body weight between forty-five to seventy five kgs .
- Allergy to local anaesthetics.
- Patients with chest deformity & clavicle fracture.
- Patients with significant pulmonary pathology.
- Patients with coagulopathies.
- Pre-existing motor and sensory deficit in the operative limb Active infection at the site of the injection.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Onset of sensory block & motor block Onset of sensory block, motor block will be calculated at baseline at 0 mins, at 5 mins, 10mins, 15mins, at 20mins and at 30 mins. Time of achieving complete sensory & motor block. Onset of sensory block, motor block will be calculated at baseline at 0 mins, at 5 mins, 10mins, 15mins, at 20mins and at 30 mins.
- Secondary Outcome Measures
Name Time Method Time taken to visualize & identify anatomy of the structures(of the area of interest) under USG guidance to evaluate the block performance time as well as adverse occurrences including pneumothorax, Horners syndrome, and inadvertent vascular puncture
Trial Locations
- Locations (1)
Silchar medical college
🇮🇳Cachar, ASSAM, India
Silchar medical college🇮🇳Cachar, ASSAM, IndiaDr Deepannita SutradharPrincipal investigator7002209146dipanitasutradhar@gmail.com