The intertruncal approach of supraclavicular brachial plexus block presenting advantages over the traditional technique. It reduces the risk of pleural puncture, requires less anesthetic volume, accelerates onset time, and enhances effectiveness in sensory and motor blockade Intertruncal approach, Classical approach, Supraclavicular brachial plexus block, Upper extremity surgery
Conditions
Interventions
10. In the group of patients undergoing the intertruncal approach of supraclavicular brachial plexus block technique with the double-injection method, ultrasound guidance will be employed above the su
Experimental Procedure/Surgery,Experimental Procedure/Surgery
Intertruncal approach of supraclavicular brachial plexus block,Classical approach of supraclavicular brachial plexus block
Sponsors
Department of Anesthesiology
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Patients admitted to the hospital (inpatient status, wether before or after the surgery) undergoing surgery on the upper extremities, including the elbow, lower arm, wrist, and hand. 2. Patients aged 18-75 years. 3. American Society of Anesthesiologist (ASA) physical status I-III. 4. Patients admitted to the hospital (inpatient status, whether before or after the surgery). 5. Patients appreciate to participate in this study with sign
Exclusion criteria
Exclusion criteria: 1. Patients unwilling to undergo brachial plexus block 2. Patients with abnormal coagulation profiles. 3. Patients with pre-existing neurological abnormalities. 4. Patients with infections at the site of the planned injection for sensory blockade. 5. Patients with a history of allergy to local anesthetics. 6. Patients with severe respiratory conditions. 7. Patients with severe liver dysfunction (Child-Turcotte-Pugh score > 9). 8. Patients with renal dysfunction: eGFR < 60 ml/min/1.73m2 9. Patients unable to communicate/follow instructions/answer questions. 10. Patients with a BMI > 30 kg/m2 or body weight < 50 kg. 11. Patients can refuse or withdrawn anytime during the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Onset time of block At 5,10, 15, 20, 25, 30 min after anesthetic injection onset of surgery is minimal composite score of 14 points from total 16 points. Motor function is assessed by 3-point qualitative scale and sensory blockade is measured using a validated 3-point scale | — |
Secondary
| Measure | Time frame |
|---|---|
| Success rate of sensory and motor blockage of the four terminal nerve At 30 min after anesthetic injection To complete sensory and motor blockage is minimal composite score of 14 points from 16 points,Performance time Time from start ultrasound to locate the brachial plexus until the complete of anesthetic injection Quantitative measurement (min),Inadequate of sensory and motor blockage At 30 mins after perform peripheral nerve block Minimal composite score of sensory and motor blockage below 14 points from 16 points or surgeon needs to perform skin infiltration of local anesthetic agents at surgical site before perform incision,Failure of sensory and motor blockage At 30 mins after perform peripheral nerve block Minimal composite score of block below 14 with skin infiltration but paitient pain after incision , minimal composite score more than 14 but pain after incision ,change technique to GA,Hemidiaphragmatic paralysis At 30 mins after perform peripheral nerve block Diaphragmatic excursion by ultrasound,Incidence of potential complications including pneumothorax, LAST, nerve and vascular injury, Horner syndrome, localized infection and hematoma At 24 hours after perform peripheral nerve block Ordinal scale ,Patients satisfaction score At 24 hours after perform peripheral nerve block Ordinal scale | — |
Countries
Thailand
Contacts
Public ContactChoosak Tunprasit
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Outcome results
None listed