This randomized clinical study aims to compare the effects of two different ultrasound-guided infraclavicular brachial plexus block techniques-costoclavicular and lateral sagittal approaches-in patients undergoing forearm, wrist, or hand surgery. The primary objective of the study is to evaluate and compare the incidence of hemidiaphragmatic dysfunction associated with these two block techniques. Secondary outcomes include sensory and motor block characteristics, postoperative pain scores, analgesic requirements, and potential block-related complications. Eligible adult patients scheduled for elective forearm or hand surgery are randomly assigned to receive either a costoclavicular or a lateral sagittal infraclavicular nerve block using bupivacaine under ultrasound guidance. Standard general anesthesia and postoperative analgesia protocols are applied. The results of this study are expected to provide evidence on the relative safety and efficacy of these two infraclavicular block approaches, particularly regarding diaphragmatic function, and to help guide anesthesiologists in selecting the most appropriate regional anesthesia technique for upper extremity surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
91
Ultrasound-guided infraclavicular brachial plexus block performed using either the costoclavicular or lateral sagittal approach with standardized local anesthetic volume.
Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation
Ankara, Ankara, Turkey (Türkiye)
Diaphragmatic excursion
Diaphragmatic excursion measured by ultrasound during normal and deep breathing to asses the effect of costoclavicular and lateral sagittal infraclavicular block techniques.
Time frame: Baseline(pre-block) and 30 minutes after block performance.
Sensory and motor block onset time
Time from completion of the infraclavicular block to achievement of complete sensory and motor block in the radial, median, ulnar, and musculocutaneous nerve distributions. Sensory and motor function were assessed every 5 minutes for up to 30 minutes after block performance, and block onset time was defined as the time to complete block.
Time frame: Within the first 30 minutes after block performance.
Time to first postoperative analgesic requirement
Time from the end of the surgery to the first analgesic requirement.
Time frame: Within the first 24 hours postoperatively.
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