None listed
Conditions
Brief summary
Brachial plexus block is a commonly performed anaesthetic/analgesic technique for elective wrist and hand surgery. Traditionally, long acting local anaesthetic is used which provides 12-15 hours potent postoperative analgesia; however, some patients experience dissatisfaction from the inevitable proximal limb paralysis. The recent availability in the operating room of portable ultrasound equipment has made it very feasible to block, at the level of the forearm, the individual nerves supplying the wrist and hand. This enables the provision of potent analgesia but without proximal extremity motor weakness. A potential disadvantage of this approach, however, is that the duration of blockade may be shorter. The 2 approaches are to be compared in a prospective randomised manner with patient satisfaction as the primary outcome.
Interventions
Distal Peripheral Nerve Block Group: A preoperative (30 mins prior to surgery) one-off ultrasound guided block of the radial (at distal humerus), median and ulnar nerves (at the forearm level) will be performed using 3x 6 ml of ropivacaine 0.5%.Patients will also receive an ultrasound-guided infraclavicular injection of lignocaine 1.5% 30 ml with adrenaline 1/200,000 40 mins prior to surgery to cover torniquet pain.
Sponsors
Dr Michael Fredrickson
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
16 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients requiring surgical anaesthesia for hand or wrist surgery under the care of the principal and co-investigators.
Exclusion criteria
Exclusion criteria will include patient refusal for brachial plexus block, known neuropathy involving the arm undergoing surgery and known allergy to amide local anaesthetic drugs.
Outcome results
None listed