General Anesthetic, Regional Anesthesia, Upper Extremity Surgery
Conditions
Brief summary
This study compares two different anesthesia methods for upper arm and hand surgery: regional anesthesia (brachial plexus block) versus general anesthesia. Regional anesthesia numbs only the arm being operated on by injecting local anesthetic near the nerves, while the patient remains awake or lightly sedated. General anesthesia puts the patient completely asleep using medications given through a breathing tube. The main goals of this study are to compare: * How much pain patients experience after surgery * Patient satisfaction with their anesthesia * Side effects such as nausea, vomiting, or breathing problems * Time until patients are ready to go home * Overall safety of each method Participants in this study will be randomly assigned to receive either brachial plexus block or general anesthesia for their scheduled upper extremity surgery. The research team will monitor participants during surgery and follow their recovery for 24 hours after the operation. This research will help doctors and patients make better-informed decisions about which type of anesthesia may be best for upper extremity procedures.
Interventions
PROCEDUREBrachial Plexus Block
Ultrasound-guided infraclavicular brachial plexus block using local anesthetic (e.g., ropivacaine or bupivacaine). Block performed before surgery to provide regional anesthesia for upper extremity surgery.
PROCEDUREGeneral Anesthesia
Standard general anesthesia with intravenous induction and maintenance with volatile anesthetics or total intravenous anesthesia (TIVA). Endotracheal intubation or laryngeal mask airway used as appropriate.
Sponsors
Adana City Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* clusion Criteria: * Adults aged 18-65 years * ASA physical status I-II * Scheduled for elective upper-extremity orthopedic surgery * Able to provide informed consent * Able to understand and complete study questionnaires
Exclusion criteria
* Contraindications to regional anesthesia * Coagulopathy or bleeding disorders * Local infection at the block site * Patient refusal of regional anesthesia * Known allergy to local anesthetic agents * Chronic opioid use (daily use for \>3 months) * Psychiatric disorders preventing cooperation or consent * Pregnancy or breastfeeding * Severe respiratory disease (for general anesthesia group) * Pre-existing neurological deficit in the operative extremity * Emergency surgery * ASA physical status III or higher
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative Anxiety Score | Immediately before operating room entry (preoperatively) | Preoperative anxiety measured immediately prior to operating room entry using the State-Trait Anxiety Inventory-State (STAI-S) scale. STAI-S is a validated 20-item questionnaire assessing current state anxiety. Scores range from 20 to 80, with higher scores indicating greater anxiety levels. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Score | From end of surgery to 24 hours postoperatively | Pain intensity measured using Visual Analog Scale (VAS) at multiple time points after surgery. VAS scores range from 0 to 10, where 0 indicates no pain and 10 indicates worst pain imaginable. Lower scores indicate better outcome. |
| Number of Participants with Postoperative Nausea and Vomiting (PONV) | First 24 hours postoperatively | Number of participants experiencing postoperative nausea and/or vomiting requiring antiemetic treatment during the postoperative period. PONV was defined as any episode of nausea or vomiting reported by the patient or requiring rescue antiemetic medication. |
| PACU Length of Stay | From PACU admission until discharge readiness (typically 0-4 hours postoperatively | Duration of stay in the Post-Anesthesia Care Unit (PACU) measured in minutes, from admission to discharge readiness based on standardized discharge criteria (Aldrete score ≥9). Shorter stay indicates better recovery. |
| Quality of Recovery (QoR-15) Score | 24 hours postoperatively | Patient-reported quality of recovery assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire. QoR-15 is a 15-item instrument measuring five dimensions of recovery: physical comfort, emotional state, psychological support, physical independence, and pain. Each item is scored 0-10, with total scores ranging from 0 to 150. Higher scores indicate better quality of recovery. |
| Patient Satisfaction Score | 24 hours postoperatively | Overall patient satisfaction with anesthesia care measured using a numerical rating scale from 0 to 5, where 0 indicates completely dissatisfied and 5 indicates completely satisfied. Patients were asked to rate their overall satisfaction with the anesthesia experience. |
| Opioid Consumption | From end of surgery to 24 hours postoperatively | Total opioid consumption measured as morphine equivalent dose (mg) during the postoperative period. All opioid medications administered were converted to morphine equivalents using standard conversion factors. Lower consumption indicates better outcome. |
Countries
Turkey (Türkiye)
Outcome results
None listed