Comparison Between Infraclavicular Brachial Plexus Block Versus Local Infiltration for Postoperative Analgesia After Wrist Arthroscopy, a Prospective Randomized Open Label Study
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 试验地点
- 1
- 主要终点
- Pain Scores as measured by the Visual Analog Scale
研究概览
简要总结
The purpose of this study is to compare infraclavicular brachial plexus shot single shot block to local infiltration done in adult patients having wrist arthroscopy surgery. Visual analogue scores, opioid consumption, quality of recovery and quality of sleep up to 72 hours post operatively will be used for comparison.
详细描述
If the patient is willing to participate and signs the consent, he/she will be randomized to one of the two treatment groups:
- Single shot block
- Local Infiltration
In the institution investigators usually advocate for regional anesthesia and intravenous sedation for the repair of open fracture of the distal radius.
Patients will be monitored during block performance with standard ASA monitors. All patients will receive 2 L of oxygen via a nasal cannula. Sedatives will be titrated to effect. Midazolam 1-2 mg, and fentanyl 50-100 mcg will be used for sedation.
Block time out will be preformed according to standard operating procedure. All blocks will be done under ultrasound guidance. Sonosite S nerve machine will be used with a low frequency curvilinear (C5) US probe with 2-5 MHZ frequency. Both single shot and local infiltration will be performed according to the SOP in the department. Ultrasound survey of the deltopectoral groove below the clavicle will take place. The axillary artery and the three cords (posterior, medial and lateral) of the brachial plexus will be identified in short axis view deeper to the pectoralis minor muscle.
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
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients scheduled for wrist arthroscopy
- •American Society of Anesthesiologists (ASA) physical status I -III
- •Mentally competent and able to give consent for enrollment in the study
排除标准
- •Patient younger than 18 years old
- •Allergy to local anesthetics, systemic opioids (fentanyl, morphine, hydromorphone and any of the drugs included in the standard of care
- •Patients opting to go under light anesthesia and those refusing the block
- •Chronic pain syndromes; Patients will be defined to have chronic pain if they are using regular daily doses of systemic narcotics for the past 6 months prior to the surgery
- •BMI of 40 or more
研究组 & 干预措施
single shot IBP block
Subjects will receive single shot infraclavicular brachial plexus block with 20ml bolus of 0.5% ropivicaine given preoperatively to help with operative and postoperative pain
干预措施: 20ml bolus of 0.5% ropivicaine (Drug)
single shot IBP block
Subjects will receive single shot infraclavicular brachial plexus block with 20ml bolus of 0.5% ropivicaine given preoperatively to help with operative and postoperative pain
干预措施: Midazolam (Drug)
single shot IBP block
Subjects will receive single shot infraclavicular brachial plexus block with 20ml bolus of 0.5% ropivicaine given preoperatively to help with operative and postoperative pain
干预措施: Fentanyl (Drug)
local infiltration
Subjects will receive local infiltration into portal space and joint space with 10ml of 0.5% ropivicaine given intraoperatively to help with operative and postoperative pain
干预措施: 10 ml of 0.5% ropivicaine (Drug)
结局指标
主要结局
Pain Scores as measured by the Visual Analog Scale
时间窗: 72 hours
Pain scores at rest and with movement.
Participants need for pain relief as measured by opiate consumption
时间窗: 72 hours
Amount of opiate consumption
次要结局
- quality of sleep as measured by modified Pittsburgh Sleep Quality Index(72 hours)
- Quality of recovery score(7 days)
- Range of motion as measured by the Disability assessment of shoulder and hand questionnaire(3 months)