Brachial Plexus Blockade
Conditions
Keywords
Local Anesthtetics, Nerve Block, Bupivacaine, Prilocaine
Brief summary
This prospective, randomized, double blind study aims to determine the optimal volume for adequate sensorial and motor blockade following an infraclavicular block. Patients will be randomized into three groups. Using a constant dose of local anesthetics (45mg bupivacaine 180mg prilocaine), different volumes will be used in each of the groups (First group; 18mL, second group; 27mL, third group; 36mL). Onset, duration and quality of sensory and motor block will be compared for patients between groups
Detailed description
Although ultrasound guided infraclavicular nerve block is routinely used to provide anesthesia for almost all of the upper extremity surgeries, optimal volume and concentration of locak anesthetic to be administered is still a subject of debate. This prospective, randomized, double blind study aims to determine the optimal volume for adequate sensorial and motor blockade following an infraclavicular block. Patients will be randomly allocated into three groups. 81 patients (27 in each group) are planned to be enrolled in this study due to a power analysis performed (G-power ver 3.1). Using a constant dose of local anesthetics (45mg bupivacaine 180mg prilocaine), different volumes will be used in each of the groups (First group; 18mL, second group; 27mL, third group; 36mL). Onset, duration and quality of sensory and motor block will be compared for patients between groups Researchers who perform the block and assess the block quality and onset will be blinded to patients' groups. Patients will also be blinded to groups they are assigned.
Interventions
DRUGBupivacaine 0.25%
DRUGPrilocaine 1%
PROCEDUREInfraclavicular Nerve Block
Ultrasound guided infraclavicular nerve block
DRUGBupivacaine 0.167%
DRUGPrilocaine 0.66%
DRUGPrilocaine 0.5%
DEVICEUltrasound
All nerve blocks will be performed with ultrasound guidance
Sponsors
Bozyaka Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Scheduled for upper extremity surgery with infraclavicular nerve block
Exclusion criteria
* Patient Refusal * Patients younger than 18 * Patients with known local anesthetic allergies * Patients with a BMI\>30 * Diabetic Patients * Uncooperated Patients * Patients with coagulopathy or recieving anticoagulant therapy * Skin infection on injection site * Patients diagnosed with sepsis or bacteremia * Physiologic and emotional lability * Surgeries that are expected to last longer than 3 hours
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensory Block, as assessed by hollman scale for pinprick test | 0, 3rd, 6th, 9th, 12th, 20th, 25th, 30th minute | Sensorial response to pinprick will be assessed at innervation sites of ulnar median radial and musculocutaneous nerves. Innervation sites of assessment are volar skin of the fifth finger for ulnar nerve, volar skin of second finger for median nerve and dorsal, proximal of the second finger for radial nerve and skin of the anterolateral forearm for musculocutaneous nerve. |
| Motor Block, as assessed by hollman scale for motor blockade | 0, 3rd, 6th, 9th, 12th, 20th, 25th, 30th minute | Motor function for each nerve will be assessed. Movements to be evaluated are; abduction of the fingers for ulnar nerve, thumb opposition for median nerve, extension of the forearm for radial nerve and flexion of the forearm for musculocutaneous nerve. |
| Postoperative Sensory Block, as assessed by hollman scale for pinprick test | 1th hour in PACU | — |
| Postoperative Motor Block, as assessed by hollman scale for motor blockadet | 1th hour in PACU | — |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain, as assessed by visual analogue scale | 1st hour and 6th hour | In addition, patients' first complaint time of pain will be recorded by nurse |
Countries
Turkey (Türkiye)
Outcome results
None listed