Comparative Study of Two Infraclavicular Block Approaches in Forearm Surgery

Sargodha Medical College40 enrolled

Overview

It is hypothesized that retro clavicular Infraclavicular brachial plexus block is better than classical coracoid Infraclavicular brachial plexus block in patients undergoing forearm surgery

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

Conditions

Procedure Time

Interventions

Retroclavicular infraclavicular brachial plexus blockPROCEDURE

The retro clavicular approach to the Infraclavicular brachial plexus block will be performed by placing probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle insertion point was located in the supraclavicular fossa, just medial to the shoulder at a point sufficiently posterior to the clavicle and medial to the trapezius muscle insertion point on the clavicle. The needle will be inserted immediately above the clavicle in the space between the coracoid process and the clavicle and advanced from cephalad to caudal.

Classic coracoid infraclavicular brachial plexus blockPROCEDURE

The coracoid approach to the Infraclavicular brachial plexus block will be performed by placing the ultrasound probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle will be inserted cephalad to the ultrasound probe using an in-plane technique and advanced in a caudal direction toward the posterior aspect of the axillary artery, in the vicinity of the posterior cord of the brachial plexus.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients from 18-60 years. 2. Male Patients 3. Elective forearm surgery 4. BMI ≤30kg/m2 5. American Society of Anesthesiologist (ASA) Physical Status ≤III Exclusion Criteria: 1. History of known allergy or hypersensitivity against study drug. 2. Previous surgery on the same limb

Locations (1)

Dr Faisal Masood teaching Hospital Sargodha

Sargodha, Punjab Province, Pakistan

Outcomes

Primary Outcomes

1 onset of motor block.

Onset of motor block assess using modified bromage scale Score Grade of motor blockade(Modified bromage scale) 0 Normal muscle function with full range of movement of elbow, wrist and fingers . 1 Decreased muscle power so that patient can move fingers and /or wrist only 2. Complete loss of muscle function with no movement in fingers/wrist

Time frame: Intraoperatively

Onset of sensory Block

Onset of sensory block assess using pin prick method Grade of sensory blockade Score 1. Feeling sharp pinprick (no block) 0 2. Blunt sensation on pinprick (partial block 1 3. No sensation on pinprick (complete block) 2

Time frame: Intraoperatively l

Block adequate for surgery

Block adequate for surgery when there is no need for local infiltration and general anesthesia

Time frame: Intraoperatively

Needle Shadow and shaft visibility using 5 point likert scale.

NEEDLE SHADOW VISIBILITY 5-POINT LIKERT SCALE SCORE Needle tip visibility 1. Very poor 2. Poor 3. Fair 4. Good 5. Very good 5-POINT LIKERT SCALE SCORE Needle Shaft visibility 1. None of the shaft visualized 2. Only a small segment of the shaft visualized 3. Less than half of the shaft visualized 4. Almost all of the shaft visualized 5. The entire shaft visualized

Time frame: Intraoperatively

Secondary Outcomes

Rescue anesthesia requirement

Rescue anesthesia given when block is not adequate for surgery such as local infiltration and general anesthesia

Time frame: Intraoperatively after regional block

Complication

Vascular puncture and pneumothorax

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.