The primary aim of this study is to compare needle shaft visibility between the retroclavicular approach and costoclavicular 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 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. This study evaluated the effectiveness, safety and feasibility of a retroclavicular brachial plexus block as compared with costoclavicular approach for infraclavicular brachial plexus block. 60 patients scheduled for elective upper limb surgery were recruited and randomized into two groups: Retroclavicular approach for infraclavicular block (Group I), costoclavicular approach for infraclavicular block (Group R). Sensory block, adverse effects and complications were evaluated and recorded every 5 minutes until 30 min 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 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
60
Retroclavicular approach for ultrasound guided infraclavicular brachial plexus block
costoclavicular approach for ultrasound guided infraclavicular brachial plexus block
Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation
Antalya, Turkey (Türkiye)
Needle shaft visibility
Needle visibility 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 of local skin anesthesia until regional block needle removal.
Time frame: Time required in seconds for the block completion (10 minutes)
Patient satisfaction using a visual analogue scale
Using a visual analog scala, patients will quantify their satisfaction with the retroclavicular and costaclavicular technique .
Time frame: Assessed 24 hours after the block
supplemental analgesic used
The use of supplementary local anesthetic and the use of intravenous narcotics were recorded.
Time frame: 90 minutes after block completion
complications such as pneumothorax, hemothorax, intraarterial injection, intravenous injection
Asked about possible complications
Time frame: 24 hours
motor block success rate
Success is defined as complete motor block in the distribution of the radial, median, ulnar, musculocutaneous nerves of the forearm and hand
Time frame: Assessed 40 minutes after block completion
Success Rate of the sensorial Block
Success is defined as complete sensory loss in the distribution of the radial, median, ulnar, musculocutaneous, and medial cutaneous nerves of the forearm and hand
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Time frame: Assessed 30 minutes after block completion
Block performance related pain
Block performance related pain was evaluated with a visual analog scala after the removal of the needle.
Time frame: 10 minutes after the needle inserted the skin