Comparison of 90° and 120° Arm Positions in Costoclavicular Block

NCT07586670 | Not Yet Recruiting

• 1 other identifier: AEŞH-EK-2026-07
• Study Type: interventional
• Target: 106
• Locations: 0 countries
• Sites: N/A

Brief Summary

The costoclavicular approach of the infraclavicular brachial plexus block is widely used for upper extremity surgeries due to its reliable anatomy and high success rates. Patient positioning, particularly the degree of arm abduction, may influence the spread of local anesthetic and the characteristics of the block. However, the optimal arm abduction angle during this procedure remains unclear. This prospective randomized controlled trial aims to investigate the effect of two different arm abduction angles (90° and 120°) on block onset time and block success in patients undergoing hand, wrist, and forearm surgery under ultrasound-guided costoclavicular brachial plexus block. Patients will be randomly assigned to one of two groups according to the degree of arm abduction. The primary outcome is block onset time. Secondary outcomes include block success, sensory and motor block characteristics, perfusion index changes, hemodynamic parameters, readiness for surgery at 15 and 20 minutes, block performance time, need for additional anesthesia, postoperative neurological evaluation at 4 and 24 hours, complications, and patient satisfaction. The findings of this study are expected to provide evidence on optimal patient positioning to improve the effectiveness and reliability of ultrasound-guided costoclavicular brachial plexus block.

Conditions

Perfusion Index; Upper Extremity Surgery; Brachial Plexus Block; Regional Anaesthesia

Outcome Measures

Primary Outcomes (1)

• Block Onset Time

  Time from completion of local anesthetic injection to achievement of adequate sensory block sufficient for surgery, assessed by pinprick test.

  Up to 30 minutes after block performance

Secondary Outcomes (16)

• Block Success

  İntraoperative period

• Sensory Block Score

  Baseline and at 5-minute intervals up to 20 minutes after block performance.

• Motor Block Score

  Baseline and at 5-minute intervals up to 30 minutes after block performance.

• Perfusion Index

  Baseline and at 5,10,15 and 20 minutes after block performance.

• Readiness for Surgery

  15 minutes after block

Study Arms (2)

90° Arm Abduction

EXPERIMENTAL

Patients receive ultrasound-guided costoclavicular brachial plexus block with the arm positioned at 90° abduction.

Procedure: Costoclavicular Brachial Plexus Block

120° Arm Abduction

EXPERIMENTAL

Patients receive ultrasound-guided costoclavicular brachial plexus block with the arm positioned at 120° abduction.

Procedure: Costoclavicular Brachial Plexus Block

Interventions

Costoclavicular Brachial Plexus Block PROCEDURE

Ultra-sound Guided costoclavicular brachial plexus block performed for upper extremity surgery using a standard local anesthetic technique

120° Arm Abduction; 90° Arm Abduction

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged between 18 and 80 years.
• Patients scheduled for elective upper extremity surgery (hand, wrist, forearm).
• Patients classified as ASA I-III.
• Patients who provide informed consent after being informed about the study.

You may not qualify if:

• History of previous surgery, scar tissue, tumor, or trauma that may alter brachial plexus anatomy.
• Presence of infection, hematoma, severe edema, burn, or open wound at the block application site.
• Known allergy to local anesthetics or other medications used in the study.
• Coagulopathy, use of anticoagulants, or platelet count \< 100,000/mm³.
• History of peripheral neuropathy, neurological deficit, cervical radiculopathy, or CRPS.
• Pregnancy or breastfeeding.
• Patients with BMI \< 18 kg/m².
• Patients with BMI \> 35 kg/m².
• Severe cardiac, pulmonary, renal, or hepatic failure.
• Mental retardation, communication difficulties, or lack of cooperation.
• Deformity, amputation, or large mass in the surgical extremity that may interfere with sensorimotor assessment.
• Preoperative significant sensory loss, motor weakness, or signs of neurological disease.
• Severe anemia (Hb \< 9 g/dL) or polycythemia (Hb \> 18 g/dL).
• Psychiatric disorders, substance abuse, or any condition that may interfere with study compliance.

Sponsors & Collaborators

• Ankara Etlik City Hospital: lead

Study Officials

• Reyhan Polat, Professor

  Ankara Etlik City Hospital

  STUDY DIRECTOR

Central Study Contacts

Algan TURGUT ÇARSANCAKLI, M.D.

CONTACT

+90 532 486 52 69; alganturgut@gmail.com

Reyhan POLAT, Professor

CONTACT

+90 532 673 43 10; reyhanp9@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This study is an open-label trial. Due to the nature of the intervention (different arm positions), blinding is not feasible
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Model Details: Participants will be randomly assigned to one of two parallel groups based on the degree of arm abduction (90° or 120°) during ultrasound-guided costoclavicular brachial plexus block. Outcomes will be compared between the two groups.

Study Record Dates

• First Submitted: April 7, 2026
• First Posted: May 14, 2026
• Study Start: May 15, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): August 27, 2026
• Last Updated: June 9, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share