A Comparison of ultrasound guided supraclavicular and infraclavicular blocks for hand and forearm surgeries
试验速览
- 阶段
- 2 期
- 状态
- 尚未招募
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Onset of sensory block & motor block
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Computer generated randomization
- 盲法
- Not Applicable
入排标准
- 年龄范围
- 18.00 Year(s) 至 60.00 Year(s)（—）
- 性别
- All
入选标准
- •ASA grade 1 or
- •Elective hand and forearm surgeries.
- •Patients of either sex aged eighteen to sixty years.
- •Total body weight between forty-five to seventy five kgs .
排除标准
- •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.
结局指标
主要结局
Onset of sensory block & motor block
时间窗: 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.
时间窗: 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.
次要结局
- 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)