The primary aim of this study is to compare needle tip visibility between the coracoid approach and retroclavicular approach for infraclavicular brachial plexus block in patients undergoing elective upper limb surgery. Secondary aim is to investigate the differences between the two groups in the needle shaft visibility, sensorial block success rate, block performance time, block performance related pain, motor block success rate, surgical success rate, complications, patient satisfaction, use of supplemental local anesthetic, use of analgesic.
Infraclavicular blocks are performed with different approaches. Infraclavicular block is usually traditionally performed at coracoid approach. Different approaches has been described for this block such as vertical approach. This study evaluated the effectiveness, safety and feasibility of a retroclavicular brachial plexus block as compared with traditionally coracoid approach for infraclavicular brachial plexus block. 100 patients scheduled for elective upper limb surgery were recruited and randomized into two groups: Coracoid approach for infraclavicular block (Group I), retroclavicular approach for infraclavicular block (Group R). Sensory block, adverse effects and complications were evaluated and recorded every 10 minutes until 30min after local anesthetic injection.Success rate of each nerve sensory block, complications, rate of satisfaction, rate of failure and incidence rate of adverse effects, the needle tip and shaft visibility, procedure time,duration of the block's effect, use of supplemental local anesthetic, use of analgesic.are compared with both groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
100
Coracoid approach for ultrasound guided infraclavicular brachial plexus block
retroclavicular approach for ultrasound guided infraclavicular brachial plexus block
Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation
Antalya, Turkey (Türkiye)
Needle visibility
To assess the needle visibility will be reviewed by two anesthesiologists using a 5-point Likert scale.
Time frame: 10 minutes after the needle inserted the skin
Technique duration
Number of seconds needed to complete the block, from time the first insertion of the blocking needle to its removal.
Time frame: Time required in seconds for the block completion (10 minutes)
Patient satisfaction using a visual analogue scale
Using a visual analogue scale , patients will quantify their satisfaction with the retroclavicular coracoid technique.
Time frame: Assessed 48 hours after the block
Surgical success rate
Surgical success is defined as no requirement for additional local anesthetic and the use of intravenous analgesic, rescue blocks, or general anesthesia during the surgery.
Time frame: 6 hours after the block
supplemental analgesic use
the need for additional intravenous analgesic
Time frame: 90 minutes after block completion
complications such as pneumothorax, hemothorax, intraarterial injection, intravenous injection
Patients are asked about possible complications and all the patients studied is evaluated by performing bedside ultrasound examinations of the chest before discharge.
Time frame: 24 hours
motor block success rate
Motor function is evaluate for flexion of the elbow, opposition of the thumb, and adduction of the thumb based on a three point scale (0 = normal strength, 1 = paresis, 2 = paralysis)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Assessed 40 minutes after block completion
Success Rate of the sensorial Block
Sensory assessments are performed every 5 minutes after needle removal for 30 minute in the regions of the radial, median, ulnar, musculocutaneous of the forearm based on a three point scale with cold test ( 0: normal sensation, 1:analgesia, 2: anesthesia).
Time frame: Assessed 30 minutes after block completion
Block performance related pain
Block performance related pain is evaluated with a verbal rating scale score after the removel of the needle.
Time frame: 10 minutes after the needle inserted the skin