Upper Extremity Injury Trauma
Conditions
Brief summary
In this prospective, randomized, double blinded study, the needle tip and needle shaft visibility of echogenic and nonechogenic needle were compared in ultrasound guided infraclavicular brachial plexus block. Sixty patients scheduled for upper extremity surgery were included in the study. Patients were randomised into two groups, group E (Echogenic) and group NE (Nonechogenic) with 30 subjects in each group. Under ultrasound guidance infraclavicular brachial plexus block was performed. In Group E, Pajunk Sonoplex echogenic needle was used and in Group NE, Stimuplex Braun nonechogenic needle was used. The subjective assessment for needle tip/shaft visibility as scored by the performer and the objective assessment from the recorded block procedure video were noted.
Detailed description
The aim of the investigators study was to find out the better among the echogenic and nonechogenic needle in needle tip/shaft visibility and the block success rate in ultrasound guided infraclavicular brachial plexus block. Sixty patients were randomized into two groups, Group E (echogenic group) and Group NE (nonechogenic group) with thirty patients in each group. The ultrasound imaging of each nerve block was video recorded for later analysis. Recording commenced from skin puncture and stopped at the time of final needle removal (total block time). After each block the performer was asked to subjectively score the percentage time he had visualized the needle tip and needle shaft on a 5 point scale (1 = 0%-20%, 2 = 20%-40%, 3 = 40%- 60%, 4 = 60%-80%, 5 = 80%-100%). The recorded video was later analysed by an investigator. An objective measurement of percentage needle tip visibility and needle shaft visibility was calculated for each nerve block using the formula, Time in view (needle tip) / total block time x 100 Time in view (needle shaft) / total block time x 100 The subjective assessment for needle tip/shaft visibility as scored by the performer and the objective assessment from the recorded block procedure video were noted. Other block parameters were also compared.
Interventions
DEVICEEchogenic needle - Pajunk sonoplex echogenic needle
Ultrasound guided infraclavicular brachial plexus block for upper extremity surgeries
DEVICENon Echogenic needle - Stimuplex Braun Nonechogenic needle
Ultrasound guided infraclavicular brachial plexus block for upper extremity surgeries
Sponsors
Post Graduate Institute of Medical Education and Research, Chandigarh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-60 years, both male and female scheduled for upper extremity surgery
Exclusion criteria
* Clinically significant coagulopathy * Local anesthetic allergy * Preexisting motor or sensory deficit in the operative limb * Uncontrolled hypertension and unstable Ischemic Heart disease * Body mass index \> 35 * Patients who needs general anaesthesia for surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Needle tip and shaft visibility | Duration of Block procedure | Percentage Needle Tip & shaft visibility calculated using the formula - Time in view (needle tip or shaft) / total block time\*100 |
Secondary
| Measure | Time frame |
|---|---|
| Time to onset of sensory blockade | 0- 15minutes. Time (Minutes) between finishing injection of Local anaesthetic and to no response to pin prick test. |
| Time to onset of motor blockade | 0- 20 minutes. Time (Minutes) between finishing injection of Local anaesthetic and onset of full paralysis. |
| Duration of block procedure | 5- 15 minutes. Start of skin puncture till the final needle removal |
| Duration of motor blockade | 0- 5 hours. Time (Hours) between the full paralysis and recovery of motor functions. |
| Block success rate of echogenic and Nonechogenic group. | Duration of surgery |
| Duration of sensory blockade | 0- 6 hours. Time (Hours) between the block completion and the first pain postoperatively. |
Outcome results
None listed