Comparative Study of Subcoracoid Tunnel Block Versus Costoclavicular Block

NCT07305584 | Not Yet Recruiting DMC

• 1 other identifier: ZU-IRB#1885/7-Nov-2025
• Study Type: interventional
• Target: 70
• 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 subcoracoid tunnel block or costoclavicular block for elderly patients undergoing distal upper limb surgeries.

Conditions

Distal Upper Limb Surgeries

Keywords

distal Upper Limb Surgeries Subcoracoid Tunnel Block Costoclavicular Block

Outcome Measures

Primary Outcomes (1)

• the onset time of sensory block

  the time interval between the end of total local anesthetic administration and complete sensory block

  5 minutes after the block

Secondary Outcomes (5)

• block performance time

  time of performance of the block

• 3. Time of first rescue analgesia(naluphine)

  24 hours postoperative

• Pain intensity

  basal, one, 2, 4, 8, 12, 18, 24, and 24 hours postoperative

• patient's satisfaction

  24 hours postoperative

• Incidence of block complications

  first 24 hours postoperative

Study Arms (2)

Group (S)

ACTIVE COMPARATOR

The patient will receive subcoracoid tunnel block

Other: subcoracoid tunnel block

Group (C)

ACTIVE COMPARATOR

The patient will receive costoclavicular block

Other: Costoclavicular block

Interventions

subcoracoid tunnel block OTHER

The probe will be placed with its proximal end towards the mid-clavicular point and distal end with a marker towards the apex of the axilla. A medial tilt of the probe will demonstrate the posterior and medial cords, while a slight lateral tilt of the probe will demonstrate the lateral cord. The needle entry point at the distal end of the probe will be marked. By using the in-plane technique, the needle will be advanced from a caudal to cephalad direction. The probe will be tilted medially, and the needle will be advanced to position its tip above the posterior or medial cord. The probe will be tilted laterally. The needle tip will be repositioned above the lateral cord, and the LA will be injected

Group (S)

Costoclavicular block OTHER

. The key anatomical structures will be identified under ultrasound: the pectoralis major muscle, subclavius muscle, and three brachial plexus cords (lateral, medial, and posterior) clustered tightly lateral to the axillary artery, along with the axillary artery and vein. The needle will be inserted by the in-plane technique from lateral to medial. The needle tip will be advanced through subcutaneous tissue and subclavius, aiming to land in the costoclavicular fascial plane between the cords, ideally between the lateral and posterior cords and superficial to the medial cord, without traversing neural structure by multipoint strategy, and local anesthesia will be injected.

Group (C)

Eligibility Criteria

• Age: 65 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Patients acceptance to share in the study.
• Patients with ASA physical status I-II.
• Patients with a body mass index (BMI): of 18.5-30 kg/m2.
• Patients undergoing distal upper limb surgeries not more than 2 hours.

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 respiratory insufficiency.
• Patients with coagulation disorders or taking drugs affecting surgical hemostasis.
• Patients with pre-existing neurological deficits

Sponsors & Collaborators

• Zagazig University: lead

Study Sites (1)

faculty of medicine,zagazig university Egypt

Zagazig, Egypt

Location

Related Publications (1)

• Kaya S, Sahap M, Demirtas K. Comparison of costoclavicular and lateral sagittal infraclavicular approaches in ultrasound-guided brachial plexus block. Agri. 2025 Jan;37(1):32-41. doi: 10.14744/agri.2024.34022.

  PMID: 39835953 BACKGROUND

Study Officials

• Howida A Kamal, MD

  faculty of medicine,zagazig university Egypt

  STUDY DIRECTOR

Central Study Contacts

Marwa M Medhat, MD

CONTACT

01002828937; medhatmarwa9@gmail.com

Howida A Kamal, MD

CONTACT

01225096755; K.Howida@yahoO.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, 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: December 12, 2025
• First Posted: December 26, 2025
• Study Start: January 1, 2026
• Primary Completion: January 1, 2026
• Study Completion: April 1, 2026
• Last Updated: December 30, 2025

Record last verified: 2025-12

Locations

EG (1)