Forearm Surgery, Interscalene Analgesia, Tourniquet Pain, US-Guided Supraclavicular Block
Conditions
Keywords
Intercostobrachial Nerve Block, PCA with Fentanyl
Brief summary
The etiology of tourniquet pain is complex, and the study team hypothesizes that blocking with Interscalene brachial plexus block (ISBPB) is more efficient in decreasing the incidence of tourniquet pain in comparison with other techniques. As there is a paucity of studies that evaluate the effect of intercostobrachial nerve (ICBN) block and ISBPB and Patient-Controlled Analgesia (PCA) with a supraclavicular brachial plexus block (SCBPB) on tourniquet pain in forearm surgery, Therefore, we established this randomized study to compare ISBPB and ICBN and PCA with fentanyl with SCBPB in terms of the incidence and severity of tourniquet pain in patients undergoing forearm surgery.
Interventions
Patients will be provided with midazolam (up to 2 mg) if requested. No opioids will be administered before the incision. At the first patient complaint of pain, the intraoperative anesthesia team will document the quality and location of pain, and 50 microgram of fentanyl will be administered if the patient requested it or pain score more than 3
Sponsors
Al-Azhar University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* aged more than 18 years, * ASAI-III patients * scheduled to undergo orthopedic or plastic surgery distal to the elbow with an anticipated tourniquet duration greater than 45 min. * desiring regional anesthesia as the primary anesthetic.
Exclusion criteria
* Contraindication to regional anesthesia. * Allergy to local anesthetics. * Primary block failure. * If patients desired deep intraoperative sedation. * Clinically significant cognitive impairment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of tourniquet pain | 2 hours | The incidence of tourniquet pain will be assessed by the patient's VAS score. The Visual Analogue Scale (VAS) measures pain intensity. The VAS consists of a 10cm line, with two end points representing 0 ('no pain') and 10 ('pain as bad as it could possibly be'). The patient is asked to rate their current level of pain by placing a mark on the line. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hemodynamics | 2 hours | Hemodynamics up to 2 hours postoperative (heart rate, mean arterial blood pressure. Mean arterial blood pressure and heart rate will be recorded at baseline and every 5 min till the end of the procedure. |
| The incidence of adverse reactions | 2 hours | The incidence of adverse reactions (Pneumothorax, Horner's syndrome) will be evaluated. |
| Patients' satisfaction | 24 hours | Patients' satisfaction will be measured immediately postoperative and after 24 hours using a five-point Likert scale consisting of very dissatisfied, dissatisfied, unsure, satisfied, and very satisfied. |
Countries
Egypt
Contacts
Primary ContactNeveen A. Kohaf, Ph.D
Outcome results
None listed