Contusion Wrist or Hand, Crush Injury Wrist or Hand
Conditions
Brief summary
In the transarterial technique for axillary brachial plexus block, the axillary artery is intentionally punctured to indicate placement of the needle within the neurovascular sheath; local anesthetic is then injected deep and superficial to the axillary artery.
Detailed description
To lessen the risk for hematoma and intravascular injection, several modifications, such as the multi-injection perineural technique, have become popular. These techniques require a high degree of technical skill and multiple needle passes, and also carry potential for injury. In this study, the investigators will compare an ultrasound-guided equivalent of the transarterial technique (periarterial injections) to a commonly used multi-injection perineural technique.
Interventions
PROCEDUREUS-guided periarterial techique
The needle will be inserted in the axillary fossa in-plane (cranial to caudal) close to the intersection of the pectoralis and biceps muscles. Two separate injections of local anesthetic will be made deep and superficial to the axillary artery
PROCEDUREUS-guided multi-injection technique
The median, ulnar and radial nerves will be identified by ultrasound. Local anesthetic will be injected adjacent to each nerve
Sponsors
North American Institute for Continuing Medical Education (NAICE)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1. Inclusion criteria: \- Patients (ASA physical status I-III) scheduled to undergo hand or wrist surgery under axillary brachial plexus block 2.
Exclusion criteria
* Patients with pre-existing neuropathy * Patients with allergy to local anesthetics * Patients with prior surgery in the ipsilateral axilla * Pregnant patients * Patients with difficulties in communication
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Block procedure time for the axillary brachial plexus block | time of the block achievement will be recorded up to 15 minutes |
Secondary
| Measure | Time frame |
|---|---|
| Onset of the block | outcome measure will be measured up to 30 minutes a |
| Time to request pain medication | participants will be followed for 3 days |
| Block success rate | participants success or block failure within 24 hours |
Countries
Belgium
Outcome results
None listed