Ultrasound Guidance Intercostobrachial Nerve Block in AVF Superficialization

NCT07852351 | Not Yet Recruiting DMC

• 1 other identifier: AVF2026
• Study Type: interventional
• Target: 76
• Locations: 0 countries
• Sites: N/A

Brief Summary

The present clinical study will be undertaken to evaluate and compare the clinical efficacy of two different volumes of distal ICBN block when combined with a baseline supraclavicular brachial plexus block during superficialization of upper arm arteriovenous fistula

Conditions

Supraclavicular Plexus Block Procedure (SCPB); ESRD

Keywords

esrd; Supraclavicular Plexus Block Procedure (SCPB)

Outcome Measures

Primary Outcomes (1)

• Comparing the incidence of successful complete sensory block

  successful complete sensory block between the two techniques at 30 minutes after injection using cold sensitivity test.

  baseline

Study Arms (2)

Supraclavicular Plexus Block Procedure (SCPB)

EXPERIMENTAL

Procedure: Supraclavicular Plexus Block Procedure (SCPB)

Distal Intercostobrachial Nerve Block

EXPERIMENTAL

Procedure: Distal Intercostobrachial Nerve Block

Interventions

Distal Intercostobrachial Nerve Block PROCEDURE

Ultrasound Positioning and Administration: The transducer will be placed transversely across the inner aspect of the arm, directly beneath where the pectoralis major muscle attaches. Infiltration Technique: Probe transversely across the axillary fold/proximal medial arm. Identify pectoralis major anteriorly and latissimus dorsi posteriorly. The target is the subcutaneous plane superficial to the brachial fascia, spanning between these muscular boundaries. Patients will be divided into two equal groups. Group H will be injected with 12 milliliters of bupivacaine 0.25%, and Group L will be injected with 6 milliliters of bupivacaine 0.25%, while advancing the needle so the LA forms a continuous subcutaneous spread from the pectoralis major side toward the latissimus dorsi side

Distal Intercostobrachial Nerve Block

Supraclavicular Plexus Block Procedure (SCPB) PROCEDURE

supine with the head turned approximately 30° away from the surgical side, and a small towel will be positioned between the scapulae to optimize access. After aseptic preparation, a high-frequency linear US probe (6 - 12 MHz) covered with a sterile sheath will be placed in the coronal-oblique plane just superior to the clavicle and lateral to the sternocleidomastoid muscle to visualize the subclavian artery medially, the brachial plexus divisions as a cluster of hypoechoic round structures lateral to the artery, and the first rib and pleura as hyperechoic lines deep to the artery. Using an in-plane lateral-to-medial approach, a 22-G, 80-mm insulated block needle will be advanced under continuous US guidance toward the "corner pocket" bordered by the subclavian artery medially, the first rib inferiorly, and the brachial plexus laterally. After negative aspiration, Ten mL of bupivacaine 0.3% will be injected into the corner pocket. needle will be redirected to deposit additional 3 - 5 mL

Supraclavicular Plexus Block Procedure (SCPB)

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adult patients aged 18 to 65 years of either sex
• Patients scheduled for elective upper-arm AVF superficialization (brachiobasilic or brachiocephalic)
• ASA physical status II, III (common in chronic kidney disease patients)

You may not qualify if:

• Pre-existing peripheral neuropathy or severe neurological deficits in the operative upper extremity.
• Cognitive impairment, psychiatric disorders, or an inability to comprehend and communicate the pain scoring scales
• Patients on chronic opioid use
• Local infection, severe dermatitis, or anatomical distortions at the proposed needle insertion sites.
• Known allergy or hypersensitivity to local anesthetics.
• Patient refusal of regional anesthesia techniques.

Sponsors & Collaborators

• Assiut University: lead

MeSH Terms

Conditions

Kidney Failure, Chronic

Condition Hierarchy (Ancestors)

Renal Insufficiency, Chronic; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: September 24, 2026
• First Posted: October 1, 2026
• Study Start: October 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): March 1, 2028
• Last Updated: October 1, 2026

Record last verified: 2026-09