The Need for Supplemental Blocks in Infraclavicular Brachial Plexus Blocks

NCT04102358 | Completed

• 1 other identifier: U1111-1240-8832
• Study Type: observational
• Target: 139
• Locations: 1 country
• Sites: 1

Brief Summary

Theoretically, all surgeries below mid-humerus can be done under infraclavicular (IC) blocks. Following the introduction of ultrasonography (USG) to clinical anesthesia, plexus, and nerve blocks under the guidance of USG have gained wide acceptance for the high rates of block success and low risk of complications (1). In this study, the main aim is to evaluate the single injection and triple injection techniques in IC blocks with a USG-guided medial approach in terms of block success and the need for supplementary blocks. The secondary goals are to compare the complication rates and sensory block durations and to discuss the possible reasons for the failure of the blocks.

Conditions

Anesthesia, Regional

Keywords

Vertical infraclavicular block; brachial plexus anatomy

Outcome Measures

Primary Outcomes (1)

• Supplemented blocks

  30 minutes after the block, if one or two of the median, radial, ulnar or musculocutaneous nerves were still unblocked, these nerves were located either with a peripheric nerve stimulator or an ultrasound, in the axilla or on the more distal parts of their traces on arm and forearm and then supplemented.

  1 hour

Secondary Outcomes (4)

• Complete Failure

  30 minutes

• Recovery of sensory block

  24 hours

• Discomfort during IC block

  1 hour

• Inadvertent vascular puncture

  1 hour

Study Arms (2)

Single injection

Patients who received an infraclavicular block with a single injection technique were included in Group-S.

Procedure: Medial approach infraclavicular block with single injection

Triple injection

Patients who received an infraclavicular block with a triple injection technique were included in Group-T.

Procedure: Medial approach infraclavicular block with triple injection

Interventions

Medial approach infraclavicular block with single injection PROCEDURE

infraclavicular blocks performed with single injection

Single injection

Medial approach infraclavicular block with triple injection PROCEDURE

infraclavicular blocks performed with triple injection

Triple injection

Eligibility Criteria

• Age: 14 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

patients underwent surgery for upper extremity under medial approach infraclavicular block between October 2017 and March 2019

You may qualify if:

• ASA physical status I-III
• upper extremity surgery
• blocks were performed by the same anesthesiologist

You may not qualify if:

• non-cooperative patients
• refusal of the regional anesthesia
• known neuropathy
• different technique used for infraclavicular brachial plexus blocks (lateral sagittal, coracoid, …etc.)
• known allergy to local anesthetic drugs.

Sponsors & Collaborators

• Derince Training and Research Hospital: lead

Study Sites (1)

Derince Training and Research Hospital

Kocaeli, Derince, 41900, Turkey (Türkiye)

Location

Related Publications (3)

• Abrahams MS, Aziz MF, Fu RF, Horn JL. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2009 Mar;102(3):408-17. doi: 10.1093/bja/aen384. Epub 2009 Jan 26.

  PMID: 19174373 BACKGROUND

• Li JW, Songthamwat B, Samy W, Sala-Blanch X, Karmakar MK. Ultrasound-Guided Costoclavicular Brachial Plexus Block: Sonoanatomy, Technique, and Block Dynamics. Reg Anesth Pain Med. 2017 Mar/Apr;42(2):233-240. doi: 10.1097/AAP.0000000000000566.

  PMID: 28157792 BACKGROUND

• Kilka HG, Geiger P, Mehrkens HH. [Infraclavicular vertical brachial plexus blockade. A new method for anesthesia of the upper extremity. An anatomical and clinical study]. Anaesthesist. 1995 May;44(5):339-44. doi: 10.1007/s001010050162. German.

  PMID: 7611581 BACKGROUND

MeSH Terms

Interventions

Injections

Intervention Hierarchy (Ancestors)

Drug Administration Routes; Drug Therapy; Therapeutics

Study Officials

• Tuncay Colak, Prof

  Kocaeli University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 23, 2019
• First Posted: September 25, 2019
• Study Start: October 1, 2017
• Primary Completion: March 31, 2019
• Study Completion: May 30, 2019
• Last Updated: February 20, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Data will be available within 6 months of study completion.
• Access Criteria: Data access requests will be reviewed by the researchers. Requestors will be required to sign a Data Access Agreement.

Locations

TU (1)