Dual Endpoint Nerve Stimulation Versus Ultrasound in Infraclavicular Block for Hand Surgery

University Health Network, Toronto106 enrolled

Overview

Current best practice for performance of infraclavicular block dictates the use of a dual-endpoint nerve stimulation technique that still only results in a 79% success rate. Use of an ultrasound-guided technique has the potential to significantly improve success. A randomized, controlled study to evaluate this area remains to be performed and is required to demonstrate to anesthesiologists that an ultrasound-guided approach should supersede nerve stimulation as the technique of choice for infraclavicular block.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

106

Conditions

Hand Surgery

Interventions

Ultrasound Guided Infraclavicular Nerve BlockPROCEDURE

Use of Ultrasound to help guide needle placement and local anesthetic injection during infraclavicular nerve block.

Dual-Endpoint nerve stimulationPROCEDURE

Use of dual-endpoint nerve stimulation to guide needle placement and local anesthetic injection during infraclavicular nerve block.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing elective upper limb surgery at or below the elbow. * Patients aged \>18 and \<80 years * ASA I-III * BMI\<35 Exclusion Criteria: * Inability to read, write or speak English. (This is necessary because subjects will have to follow detailed instructions to allow testing of motor and sensory function. It is not feasible to have an interpreter present in the block room during performance of these procedures) * Contraindication to brachial plexus block * Existing neurological deficit in the area to be blocked * Known loco-regional malignancy or infection * Coagulopathy * Allergy to local anesthetic agents. * Chest or shoulder deformities * Severe respiratory disease * Healed but dislocated clavicle fracture

Locations (1)

Colin McCartney

Toronto, Ontario, Canada

Outcomes

Primary Outcomes

To compare ultrasound-guided infraclavicular block with conventional dual-endpoint nerve stimulator guided infraclavicular block with regards to block success, ease of nerve localization, speed of onset, duration of block and complications.

Data from ClinicalTrials.gov

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