Prospective Clinical Trial Comparing Infraclavicular Versus Axillary Approach to Brachial Plexus Block

N/AUnknownNCT02208245

Federal University of São Paulo46 enrolled

Overview

The brachial plexus block is an anesthetic technique often used for surgical procedures of the upper limb. To get the brachial plexus block, several routes can be used, including the axillary and infraclavicular approach. Few studies have compared these techniques, considering the time to perform the block, the onset time and success rate, with conflicting results. Furthermore, there is little information in the literature comparing the length of postoperative analgesia provided by these techniques. Therefore, the investigators designed this study in order to elucidate the differences between these two techniques to assist the anesthesiologist to choose the best of them in clinical practice.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Scaphoid Fractures Distal Radius Fractures Wrist Injury Arthrodesis

Interventions

Ultrasound: Axillary blockDEVICE

Ultrasound guided axillary block

Ultrasound: Infraclavicular blockDEVICE

Ultrasound guided infraclvicular block

RopivacaineDRUG

20 ml of ropivacaine 0,5% in both groups ( axillary block and infraclavicular block)

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age older than 18 years and less than 70 years * consent informed signed by the patient * candidates for surgical intervention of scaphoid fractures, distal radius fractures and wrist arthrodesis * American Society of Anesthesiology physical status I, II and III * body mass index (BMI) \<35 kg / m². Exclusion Criteria: * cognitive impairment or active psychiatric condition * infection at the puncture site * bleeding disorders * history of allergy to ropivacaine

Outcomes

Primary Outcomes

postoperative analgesia

All patients will be contacted on the first postoperative day to tell the time of onset of pain postoperatively. The duration of postoperative analgesia is defined as the interval between the end of local anesthetic injection and the onset of postoperative pain reported by the patient.

Time frame: first postoperative day

Secondary Outcomes

local anesthetic pharmacokinetics

Venous blood samples will be taken from some patients through a cannula. The samples will be used for the determination of serum levels achieved after ropivacaine blockade. Samples will be taken every 15 minutes during the first hour, every 30 minutes during the second hour and 4 hours after the blockade. These samples will be analyzed using the technique of high performance liquid chromatography coupled with mass spectrometry.

Time frame: During the procedure