Patients for upper limb surgeries who are candidates for infraclavicular block will be screened. Two techniques of infraclavicular block will be compared. Measured outcomes are performance times, block onset times, patient satisfaction, quality of block, and requirement for supplementary analgesia.
Infraclavicular brachial plexus block under ultrasound guidance is used for surgeries on the upper limb. Traditionally, the block is performed at the lateral infraclavicular fossa where the cords are variable in position relative to the axillary artery. A recently introduced technique is the costoclavicular approach where the cords are viewed as relatively more superficial and clustered together compared to the traditional technique. Those meeting the inclusion criteria and will consent to participate in the study will be randomized to have either an infraclavicular block in the paracoracoid approach (Group 1) or an infraclavicular block in the costoclavicular approach (Group 2). All groups will have the same injectable volume (35 mls) and local anesthetic concentration (ropivacaine 0.5%). There will be 35 study patients for each group for a total of 70 patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
70
Local anesthetic
Ultrasound guided block
St. Joseph's Hospital
London, Ontario, Canada
Block onset time
From the time needle is removed from the patient's skin up to the time when block is considered adequate for surgery
Time frame: 1 hour
Procedure duration
From the time the US probe touches the skin to the time the needle is removed
Time frame: 1 hour
Quality of block
Time frame: 1 hour
Patient satisfaction
Satisfaction score (VAS ranging from 0 = completely dissatisfied to 10 = completely satisfied)
Time frame: 1 day
Requirement for supplemental analgesia or anesthesia
Quality of block will be assessed if adequate for surgery
Time frame: 1 day
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