Procedure Time
Conditions
Brief summary
It is hypothesized that retro clavicular Infraclavicular brachial plexus block is better than classical coracoid Infraclavicular brachial plexus block in patients undergoing forearm surgery
Interventions
PROCEDURERetroclavicular infraclavicular brachial plexus block
The retro clavicular approach to the Infraclavicular brachial plexus block will be performed by placing probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle insertion point was located in the supraclavicular fossa, just medial to the shoulder at a point sufficiently posterior to the clavicle and medial to the trapezius muscle insertion point on the clavicle. The needle will be inserted immediately above the clavicle in the space between the coracoid process and the clavicle and advanced from cephalad to caudal.
PROCEDUREClassic coracoid infraclavicular brachial plexus block
The coracoid approach to the Infraclavicular brachial plexus block will be performed by placing the ultrasound probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle will be inserted cephalad to the ultrasound probe using an in-plane technique and advanced in a caudal direction toward the posterior aspect of the axillary artery, in the vicinity of the posterior cord of the brachial plexus.
Sponsors
Sargodha Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Patients from 18-60 years. 2. Male Patients 3. Elective forearm surgery 4. BMI ≤30kg/m2 5. American Society of Anesthesiologist (ASA) Physical Status ≤III
Exclusion criteria
1. History of known allergy or hypersensitivity against study drug. 2. Previous surgery on the same limb
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 1 onset of motor block. | Intraoperatively | Onset of motor block assess using modified bromage scale Score Grade of motor blockade(Modified bromage scale) 0 Normal muscle function with full range of movement of elbow, wrist and fingers . 1 Decreased muscle power so that patient can move fingers and /or wrist only 2. Complete loss of muscle function with no movement in fingers/wrist |
| Onset of sensory Block | Intraoperatively l | Onset of sensory block assess using pin prick method Grade of sensory blockade Score 1. Feeling sharp pinprick (no block) 0 2. Blunt sensation on pinprick (partial block 1 3. No sensation on pinprick (complete block) 2 |
| Block adequate for surgery | Intraoperatively | Block adequate for surgery when there is no need for local infiltration and general anesthesia |
| Needle Shadow and shaft visibility using 5 point likert scale. | Intraoperatively | NEEDLE SHADOW VISIBILITY 5-POINT LIKERT SCALE SCORE Needle tip visibility 1. Very poor 2. Poor 3. Fair 4. Good 5. Very good 5-POINT LIKERT SCALE SCORE Needle Shaft visibility 1. None of the shaft visualized 2. Only a small segment of the shaft visualized 3. Less than half of the shaft visualized 4. Almost all of the shaft visualized 5. The entire shaft visualized |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complication | Intraoperatively | Vascular puncture and pneumothorax |
| Procedure Time | Intraoperatively | Time from insertion of needle to removal of needle |
| Rescue anesthesia requirement | Intraoperatively after regional block | Rescue anesthesia given when block is not adequate for surgery such as local infiltration and general anesthesia |
Countries
Pakistan
Outcome results
None listed