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The primary aim of this study is to compare needle shaft visibility between the retroclavicular approach and costoclavicular approach for infraclavicular brachial plexus block in patients undergoing elective upper limb surgery. Secondary aim is to investigate the differences between the two groups in sensorial block success rate, block performance time, block performance related pain, motor block success rate, surgical success rate, complications, patient satisfaction, use of supplemental local anesthetic, use of analgesic.
Infraclavicular blocks are performed with different approaches. This study evaluated the effectiveness, safety and feasibility of a retroclavicular brachial plexus block as compared with costoclavicular approach for infraclavicular brachial plexus block. 60 patients scheduled for elective upper limb surgery were recruited and randomized into two groups: Retroclavicular approach for infraclavicular block (Group I), costoclavicular approach for infraclavicular block (Group R). Sensory block, adverse effects and complications were evaluated and recorded every 5 minutes until 30 min after local anesthetic injection. Success rate of each nerve sensory block, complications, rate of satisfaction, rate of failure and incidence rate of adverse effects, the needle shaft visibility, procedure time,duration of the block's effect, use of supplemental local anesthetic, use of analgesic are compared with both groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| retroclavicular approach | Active Comparator | Patients in this group will be randomized to receive an retroclavicular approach to Ultrasound Guided Infraclavicular Brachial Plexus Nerve Block . |
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| costoclavicular approach | Active Comparator | Patients in this group will be randomized to receive an costoclavicular approach to Ultrasound Guided Infraclavicular Brachial Plexus Nerve Block . |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| retroclavicular approach | Other | Retroclavicular approach for ultrasound guided infraclavicular brachial plexus block |
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| Measure | Description | Time Frame |
|---|---|---|
| Needle shaft visibility | Needle visibility reviewed by two anesthesiologists using a 5-point Likert scale | 10 minutes after the needle inserted the skin |
| Measure | Description | Time Frame |
|---|---|---|
| Technique duration | Number of seconds needed to complete the block, from time of local skin anesthesia until regional block needle removal. | Time required in seconds for the block completion (10 minutes) |
| Patient satisfaction using a visual analogue scale |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hayri Fatih Metinyurt, MD | Antalya Training and Research Hospital | Study Director |
| Nilgun Kavrut Ozturk, MD | Antalya Training and Research Hospital | Principal Investigator |
| Ali Sait Kavakli, MD | Antalya Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation | Antalya | 07100 | Turkey (Türkiye) |
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| costoclavicular approach | Other | costoclavicular approach for ultrasound guided infraclavicular brachial plexus block |
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Using a visual analog scala, patients will quantify their satisfaction with the retroclavicular and costaclavicular technique . |
| Assessed 24 hours after the block |
| supplemental analgesic used | The use of supplementary local anesthetic and the use of intravenous narcotics were recorded. | 90 minutes after block completion |
| complications such as pneumothorax, hemothorax, intraarterial injection, intravenous injection | Asked about possible complications | 24 hours |
| motor block success rate | Success is defined as complete motor block in the distribution of the radial, median, ulnar, musculocutaneous nerves of the forearm and hand | Assessed 40 minutes after block completion |
| Success Rate of the sensorial Block | Success is defined as complete sensory loss in the distribution of the radial, median, ulnar, musculocutaneous, and medial cutaneous nerves of the forearm and hand | Assessed 30 minutes after block completion |
| Block performance related pain | Block performance related pain was evaluated with a visual analog scala after the removal of the needle. | 10 minutes after the needle inserted the skin |