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The aim of this study is to compare the combined ultrasound-guided supraclavicular brachial plexus block and distal median, radial, and ulnar nerve blocks, with supraclavicular block alone.
Sixty two patients undergoing upper extremity surgery will be randomized to supraclavicular only (Group S, n=31) or supraclavicular + distal (Group SD, n=31) group. Patients in group S will receive 32 mL of lidocaine 1.5% + epinephrine 5µg/mL and in group SD receive 20 mL of lidocaine 1.5% + epinephrine 5µg/mL followed by a distal median, radial, and ulnar nerve blocks using 50:50 mixture of lidocaine 2% + levobupivacaine 0.5% (4 mL/nerve). Sensory and motor block of the ulnar, median, radial and musculocutaneous nerves will be assessed every 5 minutes starting at the 10th minutes. The imaging, needling and performance times will be recorded. Also the onset and anesthesia related times, need for analgesic and first analgesic time will be noted.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| supraclavicular block | Active Comparator | A supraclavicular block with 32 mL of lidocaine 1.5% + epinephrine 5µg/mL was performed for the anaesthetic management of the forearm and hand. |
|
| Supraclavicular and median, ulnar, radial blocks | Active Comparator | Patients in this group received 20 mL of lidocaine 1.5% + epinephrine 5µg/mL for supraclavicular block and after the supraclavicular block they recieved a distal median, radial, and ulnar nerve blocks using 50:50 mixture of lidocaine 2% + levobupivacaine 0.5% (4 mL/nerve). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| intravenous cannulation. | Procedure | A 18-or 20-gauge intravenous (iv) catheter was placed to the contralateral arm according to the surgical site |
|
| Measure | Description | Time Frame |
|---|---|---|
| The time required after a supraclavicular block alone or a supraclavicular block combined with distal blocks, to achieve a sensory and motor block needed for surgery. | The onset time of supraclavicular plexus block and the onset time of supraclavicular block combined with distal median, radial, and ulnar nerve blocks will be followed up. The time needed to achieve a surgical block will be assessed in both groups. The difference between the 2 groups will be compared and analysed. For this an investigator blinded to the group allocation will evaluate the sensorial pinprick and motor blocks of the ulnar, median, radial and musculocutaneous nerves every 5 minutes starting at the 10th minutes until 30th minutes. | All patients will be followed up during the block procedure and during the surgery. Also, after the surgery patients will be followed up to 7 days postoperatively. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Basak Ceyda Meco, MD, DESA | Ankara University Faculty of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara University Faculty of Medicine, Ibni Sina Hospital colonoscopy lab | Ankara | 06700 | Turkey (Türkiye) |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Jan 9, 2014 | |
| Reset | Feb 25, 2014 | |
| Release | Apr 1, 2014 |
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| Supraclavicular block and ultrasound-guided ulnar, median and radial nerve blocks. | Procedure | Supraclavicular block with 20 mL of lidocaine 1.5% + epinephrine 5µg/mL and the addition of ultrasound-guided ulnar, median and radial nerve blocks. For that 12 mL of local anesthetic solution of a 50:50 mixture of lidocaine 2% and levobupivacaine 0.5% (4 mL/nerve) was used. |
|
| Intravenous cannulation. | Device | A 18-or 20-gauge intravenous (iv) catheter was placed to the contralateral arm according to the surgical site |
|
| Routine ASA monitoring | Device | Monitorization with ECG, noninvasive blood pressure and spO2. |
|
| Premedication midazolam | Drug | Premedication with 0.03 mg/kg midazolam iv |
|
| Lidocaine | Drug |
|
| Epinephrine | Drug |
|
| Levobupivacaine | Drug |
|
| Reset | May 1, 2014 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jan 9, 2014 | Feb 25, 2014 | |||
| Apr 1, 2014 | May 1, 2014 |
| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D004837 | Epinephrine |
| D000077554 | Levobupivacaine |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D002045 | Bupivacaine |
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