Hand Injury
Conditions
Brief summary
Patients will be randomized to one of two groups: 1. Supraclavicular group: supraclavicular brachial plexus block performed with the aid of ultrasound; 2. Retroclavicular group: retroclavicular brachial plexus block performed with the aid of ultrasound.
Detailed description
The study will be proposed to all patients undergoing formarm or hand surgery under brachial plexus block. Patients will be randomized to one of two groups The first group - supraclavicular group - will receive an ultrasound-guided brachial plexus block via the supraclavicular approach, by injection of 30 ml of a mixture of ropivacaine 0.5 % + mepivacaine 1 %. The second group - retroclavicular group - will receive an ultrasound-guided brachial plexus block via the retroclavicular approach, by injection of 30 ml of a mixture of ropivacaine 0.5 % + mepivacaine 1 %. Primary outcome is success rate at 30 minutes after the injection defined as loss of sensation to pinprick in the forearm and hand. Secondary outcomes are: needling time, time to first analgesic request, postoperative opioid consumption, pain scores at 12 and 24 hours postoperatively, block-related complications, and patient satisfaction.
Interventions
PROCEDUREretroclavicular block
retroclavicular block for forearm or hand surgery
PROCEDUREsupraclavicular block
supraclavicular block for forearm or hand surgery
Sponsors
Hôpital du Valais
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients who undergo forearm or hand surgery under brachial plexus block.
Exclusion criteria
* History of allergic reaction to local anaesthetics * Peripheral neuropathy * Renal or hepatic insufficiency * Coagulation disorders
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success rate (loss of sensation to pinprick in the forearm and hand) | 30 minutes after the injection |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to first analgesic request | 24 hours | — |
| Block-related complications | 24 hours | — |
| Postoperative opioid consumption on postoperative day 1 | 24 hours | — |
| Needling time in seconds | 15 min | — |
| Pain scores on postoperative day 1 | 24 hours | measured on a visual analogue scale between 0 and 100 |
| Patient satisfaction as assessed by numerical rating scale | 24 hours | Patient satisfaction on a scale between 0 (= completely dissatisfied) and 10 (= completely satisfied) |
| Pain scores at 12 hours postoperatively | 12 hours | measured on a visual analogue scale between 0 and 100 |
Countries
Switzerland
Outcome results
None listed