Comparative Study Between Two Different Approaches of Brachial Plexus Block: Supraclavicular Approach and Retroclavicular Approach

NCT05187988 | Completed

• 1 other identifier: Soh-Med-21-11-02
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

In this study investigators will compare two different approaches of brachial plexus block ;supraclavicular approach and retroclavicular approach regarding success rate, duration of block, complications

Conditions

Brachial Plexus Block

Outcome Measures

Primary Outcomes (3)

• Block success rate

  Investigator will compare success rate of both types of block and which one is more likely to be successfully administrated

  one year

• Complications

  Investigators will compare complications like pneumothorax,nerve injury,bleeding and which one is more likely to cause complications

  one year

• Duration of sensory and motor blockade

  Time which each procedure will take to block sensory and motor stimuli

  one year

Secondary Outcomes (2)

• Duration of procedure

  one year

• Number of needle passes

  one year

Study Arms (2)

Supraclavicular approach group

ACTIVE COMPARATOR

probe placed firmly over the supraclavicular fossa, parallel to the clavicle to obtain a short-axis view of the divisions of the brachial plexus and the subclavian artery, lying on the first rib After skin infiltration with lidocaine 2% a 23-gauge 70mm block needle inserted in-plane with the ultrasound beam, in a lateral-to-medial direction, until the needle tip's positioned at the junction of the first rib and subclavian artery

Procedure: supraclavicular brachial plexus block

Retroclavicular approach group

ACTIVE COMPARATOR

the probe will be placed below and perpendicular to the clavicle, in a paramedian sagittal plane, medial to the coracoid process, to obtain a short-axis view of the cords of the brachial plexus and the axillary vessels. The needle will be then inserted in the supraclavicular fossa, approximately 1 cm posteriorly to the clavicle, and advanced in plane and strictly parallel to the ultrasound transducer. After passing the initial blind zone of about 2 cm caused by the acoustic shadow of the clavicle, the needle tip is constantly seen, until it is positioned posterior to the axillary artery

Procedure: Retroclavicular brachial plexus block

Interventions

supraclavicular brachial plexus block PROCEDURE

group will receive brachial plexus block above clavicle,Injection of anaesthetic will be done in brachial plexus around subclavian artery

Supraclavicular approach group

Retroclavicular brachial plexus block PROCEDURE

group will receive brachial plexus block inferior to the clavicle,injection of anaesthetic will be done around axillary artery

Retroclavicular approach group

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• patients doing distal arm surgery, elective , 18 to 60 years old , will be included in double blinded randomized study.

You may not qualify if:

• Patient refusal .
• local infection or deformity at the block site.
• Patient with significant neurological , psychiatric or neuromuscular disease.
• Pregnancy or lactating women .
• Coagulopathy .
• Morbid obesity .
• History of allergy to local anaesthetics

Sponsors & Collaborators

• Sohag University: lead

Study Sites (1)

Sohag University Hospital

Sohag, Egypt

Location

Related Publications (4)

• Albrecht E, Mermoud J, Fournier N, Kern C, Kirkham KR. A systematic review of ultrasound-guided methods for brachial plexus blockade. Anaesthesia. 2016 Feb;71(2):213-27. doi: 10.1111/anae.13347. Epub 2015 Dec 16.

  PMID: 26670119 BACKGROUND

• Yazer MS, Finlayson RJ, Tran DQ. A randomized comparison between infraclavicular block and targeted intracluster injection supraclavicular block. Reg Anesth Pain Med. 2015 Jan-Feb;40(1):11-5. doi: 10.1097/AAP.0000000000000193.

  PMID: 25478758 BACKGROUND

• Charbonneau J, Frechette Y, Sansoucy Y, Echave P. The Ultrasound-Guided Retroclavicular Block: A Prospective Feasibility Study. Reg Anesth Pain Med. 2015 Sep-Oct;40(5):605-9. doi: 10.1097/AAP.0000000000000284.

  PMID: 26222346 BACKGROUND

• Grape S, Pawa A, Weber E, Albrecht E. Retroclavicular vs supraclavicular brachial plexus block for distal upper limb surgery: a randomised, controlled, single-blinded trial. Br J Anaesth. 2019 Apr;122(4):518-524. doi: 10.1016/j.bja.2018.12.022. Epub 2019 Jan 31.

  PMID: 30857608 BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: resident doctor at anasthesia department sohag university hospital

Study Record Dates

• First Submitted: November 28, 2021
• First Posted: January 12, 2022
• Study Start: January 5, 2022
• Primary Completion: September 5, 2022
• Study Completion: September 5, 2022
• Last Updated: September 8, 2022

Record last verified: 2022-09

Data Sharing

• IPD Sharing: Will share

Locations

EG (1)