Regional Anesthesia, Smoking, Cigarette
Conditions
Brief summary
The present study will be conducted involving 40 patients aged 18-65 years with ASA physical status I and II, scheduled for acute or elective hand or forearm surgery under the lateral infraclavicular block. Patients will be divided into two groups based on smoking status: Group I (non-smokers) and Group II (smokers who smoke ≥20 cigarettes/day for over 1 year). Using a high-frequency linear ultrasound transducer, the axillary artery, vein, and the three nerve cords will be identified in the lateral infraclavicular region. After disinfection with ethanol-chlorhexidine, a sterile drape will be placed, and the attending anesthesiologist will perform the ultrasound-guided infraclavicular brachial plexus block with a triple injection technique. A total of 10 mL of bupivacaine 0.25% and prilocaine 0.05% will be injected at all three nerve cords. The primary outcome will be the sensory blockade onset time, while secondary outcomes will include the duration of sensory and motor blockade, motor blockade onset time, time to first postoperative rescue analgesia, and total consumption of rescue analgesia. Postoperative pain will be assessed using the Visual Analogue Scale (VAS) within the first 24 hours at intervals of 2, 4, 8, 12, 16, and 24 hours. If VAS exceeds 30 cm, rescue analgesia with 0.05 mg/kg intravenous morphine sulfate will be administered.
Interventions
None listed
Sponsors
Selcuk University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Inclusion criteria
* ASA physical status I and II * Scheduled for acute or elective hand or forearm surgery under the lateral infraclavicular block
Exclusion criteria
* morbid obesity (body mass index \> 40) * bleeding disorder * coagulopathy * medication with vitamin K antagonists * high-dose or fractionated heparin treatment * allergy to local anaesthetics * infection at the site of needle insertion * peripheral neurological disease * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensory blockade onset time | During procedure | The sensory blockade onset time will be evaluated using a cold ice pack. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of motor blockade | up to 24 hours | The duration of motor blockade will be evaluated as the time between the onset of the motor block and the achievement of Grade 0 on the modified Bromage scale. |
| Motor blockade onset time | During procedure | The motor blockade onset time will be assessed by movement at the elbow, wrist and fingers using a modified Bromage scale. |
| Duration of sensory blockade | up to 24 hours | The duration of sensory blockade will be evaluated as the time between the onset of the sensory block and the complete disappearance of the sensory blockade. |
| Consumption of rescue analgesia | During the postoperative 24-hour period. | The Visual Analogue Scale (VAS) \> 3 |
| Postoperative pain | within the first 24 hours (2, 4, 8, 12, 16, and 24 hours). | Postoperative pain was evaluated with a visual analogue scale |
| Time to need for postoperative first rescue analgesia | During the postoperative 24-hour period. | The Visual Analogue Scale (VAS) \> 3 |
Outcome results
None listed