Early Detection of Supraclavicular Brachial Plexus Block Failure Using Infrared Thermography and Perfusion Index

NCT07092891 | Not Yet Recruiting

• 1 other identifier: Brachial Plexus Block Failure
• Study Type: interventional
• Target: 80
• Locations: 0 countries
• Sites: N/A

Brief Summary

Successful peripheral nerve blockade is fundamental to modern regional anesthesia, particularly for upper limb surgeries. Ensuring the efficacy of a nerve block early in the perioperative period is critical, as delayed recognition of block failure may lead to intraoperative pain, the need for additional sedation or general anesthesia, and overall poorer patient outcomes. Conventional methods for assessing block success, such as sensory testing with pinprick or cold stimuli and motor assessment using strength scales, require patient cooperation and often take 15-30 minutes to yield definitive results. These delays are especially limiting in fast-paced surgical environments or when early decisions regarding anesthesia management are necessary. Emerging non-invasive monitoring technologies offer promising alternatives for the early, objective assessment of block efficacy. Infrared Thermography (IRT) measures skin surface temperature, which increases due to sympathetic nerve blockade-induced vasodilation.

Conditions

Regional Anaesthsia; Brachial Plexus Blocks

Keywords

Brachial Plexus Blocks; Regional Anaesthesia

Outcome Measures

Primary Outcomes (2)

• Change in Skin Temperature (°C) Measured by Infrared Thermography From Baseline to 10 Minutes Post-block.

  Mean change in skin temperature on the operative limb captured using infrared thermography at defined time points.

  Baseline, 5, and 10 minutes post-injection

• Change in Perfusion Index From Baseline to 10 Minutes Post-block

  PI measured via pulse oximeter; change calculated as ratio to baseline values.

  Baseline, 5, and 10 minutes post-injection

Secondary Outcomes (1)

• Correlation Between Changes in Skin Temperature and Perfusion Index With Sensory and Motor Block Scores at 20 Minutes

  20 minutes post-injection

Study Arms (1)

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

EXPERIMENTAL

Participants will receive an ultrasound-guided supraclavicular brachial plexus block using 30 mL of 0.5% bupivacaine for upper limb surgery. Infrared thermography and perfusion index measurements will be recorded at baseline, and at 5, 10, and 15 minutes post-block to detect early physiological changes. Clinical assessment of sensory and motor block will be performed at 20 minutes post-injection using standardized testing. The goal is to evaluate the predictive accuracy of these non-invasive measures in detecting block success or failure.

Procedure: Ultrasound-Guided Supraclavicular Block; Drug: Bupivacaine Hydrochloride 0.5 % Injectable Solution; Device: Ultrasound; Device: Infrared Thermography Camera; Device: Pulse Oximeter

Interventions

Ultrasound-Guided Supraclavicular Block PROCEDURE

Ultrasound-guided supraclavicular brachial plexus block using a high-frequency linear ultrasound probe-real-time visualization of the brachial plexus for precise anesthetic delivery.

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

Bupivacaine Hydrochloride 0.5 % Injectable Solution DRUG

30 mL used for supraclavicular brachial plexus block

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

Ultrasound DEVICE

Imaging for block placement

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

Infrared Thermography Camera DEVICE

Skin temperature monitoring

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

Pulse Oximeter DEVICE

Perfusion Index monitoring

Supraclavicular Brachial Plexus Block with Thermographic and Perfusion Monitoring

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 18-70 years
• ASA Physical Status I-III

You may not qualify if:

• General
• Coagulopathy
• Allergy to local anesthetics
• Special
• Neurological deficits in the affected limb
• Peripheral vascular disease or Raynaud's phenomenon
• Infections or skin lesions at the site of injection
• Use of a tourniquet

Sponsors & Collaborators

• Assiut University: lead

Related Publications (2)

• Gamal M, Hasanin A, Adly N, Mostafa M, Yonis AM, Rady A, Abdallah NM, Ibrahim M, Elsayad M. Thermal Imaging to Predict Failed Supraclavicular Brachial Plexus Block: A Prospective Observational Study. Local Reg Anesth. 2023 Jun 9;16:71-80. doi: 10.2147/LRA.S406057. eCollection 2023.

  PMID: 37323293 BACKGROUND

• Abdelnasser A, Abdelhamid B, Elsonbaty A, Hasanin A, Rady A. Predicting successful supraclavicular brachial plexus block using pulse oximeter perfusion index. Br J Anaesth. 2017 Aug 1;119(2):276-280. doi: 10.1093/bja/aex166.

  PMID: 28854539 BACKGROUND

MeSH Terms

Interventions

Bupivacaine; Ultrasonography

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Diagnostic Imaging; Diagnostic Techniques and Procedures; Diagnosis

Central Study Contacts

Tarek Ashraf Ibrahim Abd Al-Hafiz, resident doctor

CONTACT

+201092002284; tarek.15235463@med.aun.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: resident doctor at Assiut University hospital

Study Record Dates

• First Submitted: July 15, 2025
• First Posted: July 30, 2025
• Study Start: August 15, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: July 30, 2025

Record last verified: 2025-07