Ultrasound Guided Supraclavicular Nerve Block

The Cleveland Clinic103 enrolled

Overview

This study will test the hypothesis that sequential injection of 1.5% mepivacaine followed 90 seconds later by 0.5% ropivacaine in ultrasound guided supraclavicular block provides a quicker onset and a longer duration of analgesia than an equi-dose mixture of the two local anesthetics.

Patients will be randomized into one of two groups, Group M: Ropivacaine and Mepivacaine - subject will receive two injections before surgery begins. These two injections will consist of the mixture of mepivacaine (15 ml) and ropivacaine (15 ml). Group S: Mepivacaine followed by Ropivacaine. Subjects will receive two injections before surgery begins. One injection will contain mepivacaine (15 ml) and the other will contain ropivacaine (15 ml). On the first, second, and third mornings after surgery,subjects will be asked to rate their pain on a scale of 1 to 10. If the subject is discharged from the hospital, a telephone call will be made to the subject's home to collect this information.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

103

Conditions

Local Anesthetic

Interventions

RopivacaineDRUG

ropivacaine (15 ml).

MepivacaineDRUG

One syringe will contain mepivacaine (15 ml)

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing upper extremity procedures suitable for supraclavicular anesthesia, including but not limited to oHand surgery oForearm surgery oElbow surgery * Age between 18 and 70 years Exclusion Criteria: * Contraindications to supraclavicular block * Coagulopathy * Infection at the needle insertion site * Severe chronic obstructive pulmonary disease (COPD) * Contralateral pneumothorax or diaphragmatic paralysis * Pregnancy * Preexisting neuropathy involving the surgical limb * Routine opioid use * Inability to attain adequate ultrasound images in the supraclavicular area

Locations (1)

Cleveland Clinic

Cleveland, Ohio, United States

Outcomes

Primary Outcomes

Duration of Analgesia.

The primary outcomes will be the onset time, onset of surgical block, and duration of analgesia.

Time frame: During surgery: postoperative day 0

Secondary Outcomes

Time to Complete Motor Block

Time frame: during surgery from induction time to end case time

Time to Onset of First Sensory Block

Time frame: during surgery

Maximum Verbal Response Score (VRS) With Rest

The severity of postoperative pain was assessed by an observer blinded to treatment using a 0- to 10-point verbal response score (VRS): 0 = no pain and 10= worst pain

Time frame: through post operative day 3

Maximum Verbal Response Score (VRS) With Movement

The severity of postoperative pain was assessed by an observer blinded to treatment using a 0- to 10-point verbal response score (VRS): 0 = no pain and 10 = worst

Time frame: through post operative day 3

Duration of Analgesia

Time from the complete onset of sensory block until first request for an analgesic

Time frame: from surgery date to postoperative day 1

Total Opioid Consumption

In morphine equivalent dose

Time frame: postoperative day 1 to day 3

Data from ClinicalTrials.gov

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