Ultrasound Guided Retroclavicular Infraclavicular Versus Axillary Block as Regional Anesthesia in Obese Patients

NCT07209995 | Enrolling By Invitation DMC

• 1 other identifier: ZU-IRB#1680/23-Sep-2025
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following the ultrasound-guided retroclavicular infraclavicular approach and the axillary approach in obese patients.

Conditions

Achievement of High-quality Analgesia in Elbow Surgeries

Keywords

retroclavicular infraclavicular approach the axillary block obese patients elbow surgeries.

Outcome Measures

Primary Outcomes (1)

• Time to first analgesic request in each group

  24 hours postoperative

Secondary Outcomes (9)

• Block assessment and definition of successful block

  30 minutes after the block

• Imaging time

  the time between probe application and insertion of the needle

• Needle time

  the time between insertion of the needle and complete injection of local anesthetic

• -Procedure time

  the summation of the imaging and needling times

• Pain intensity

  basal, one, 2, 4, 8, 12, 16, 20 and 24 hours postoperative

Study Arms (2)

Group (R)

ACTIVE COMPARATOR

Patients will recieve retroclavicular infraclavicular brachial plexus block

Other: retroclavicular infraclavicular brachial plexus block for

Group (A)

ACTIVE COMPARATOR

Patients will receive the axillary brachial plexus

Other: axillary block

Interventions

retroclavicular infraclavicular brachial plexus block for OTHER

The patient will be placed supine, head facing the contralateral side. A high- frequency 13-6 MHz linear array transducer probe will be placed medial to the coracoid process below and perpendicular to the clavicle to obtain a short-axis view of the cords of the brachial plexus and the axillary vessels. The needle will be inserted in the supraclavicular fossa, approximately one cm posteriorly to the clavicle, and advanced in plane parallel to the probe. After passing the initial blind zone of about 2 cm caused by the clavicle's acoustic shadow, the needle tip will be continuously seen, until it appears posterior to the axillary artery. A single injection of the local an esthetic will be performed without needle repositioning unless paresthesia is elicited

Group (R)

axillary block OTHER

The axillary nerve block is performed from behind the patient with the patient seated. The axillary nerve will be identified within the quadrilateral space by placing high frequency linear probe parallel to the long axis of the humeral shaft. The nerve was identified next to the circumflex artery

Group (A)

Eligibility Criteria

• Age: 21 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients acceptance to share in the study.
• Patients with ASA physical status I-II.
• Obese patients (BMI 30-40 kg/m²) undergoing around and below elbow surgeries under regional anesthesia.
• Patients requiring a single injection infraclavicular retroclavicular brachial plexus block or axillary block for around and below elbow surgeries.

You may not qualify if:

• Patients with a history of allergic reactions or contraindications to local anesthetics.
• Patients with significant comorbidities (e.g., severe cardiovascular, neurological, or musculoskeletal disorders).
• Patients with a history of previous shoulder or clavicle surgery that may distort anatomy and affect the efficacy of the block.
• Pregnant or breastfeeding women.
• Patients with a history of systemic infections or skin infections in the area of the block.

Sponsors & Collaborators

• Zagazig University: lead

Study Sites (1)

faculty of medicine,zagazig university Egypt

Zagazig, 44519, Egypt

Location

Study Officials

• Howida A Kamal, MD

  faculty of medicine,zagazig university Egypt

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assistant professor of anesthesia and surgical intensive care (Principal Investigator)

Study Record Dates

• First Submitted: September 30, 2025
• First Posted: October 7, 2025
• Study Start: October 15, 2025
• Primary Completion: March 15, 2026
• Study Completion: April 15, 2026
• Last Updated: December 16, 2025

Record last verified: 2025-09

Locations

EG (1)