Patient Positioning on Supraclavicular Nerve Block

Blockade of the brachial plexus using a supraclavicular approach provides excellent anesthesia for upper extremity surgery. The most serious complication specific to this block is pneumothorax. Subsequent modifications of this block including the use of ultrasound have lowered the risk from 6% to <1%. Case reports remain and authors have described certain factors and strategies to reduce this risk. Most texts and journals describe the patient in a supine or semi-sitting position during the block. At the investigators institution the investigators perform the block in a semi-sitting position to facilitate needle tip visibility with ultrasound. The investigators plan to obtain ultrasound anatomic measurements in three different positions (supine, semi-sitting, sitting) using patients consented for supraclavicular nerve blocks.

Study Overview

• Status: Terminated
• Conditions: Nerve Block

• Study Type: Observational
• Enrollment (Actual): 6

Contacts and Locations

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Northwestern University Feingberg School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients 18 y/o to 65 y/o, who are scheduled to receive a ultrasound-guided supraclavicular nerve block as part of their postoperative pain management.

Description

Inclusion Criteria:

• all patients, 18 y/o to 65 y/o, who are scheduled to receive an ultrasound- guided supraclavicular nerve block

Exclusion Criteria:

• patient refusal to be included in the study,
• the presence of language barrier that inhibits proper communication with the patient, contraindications to regional anesthesia (local infection, severe pulmonary disease, or preexisting neuropathy)
• history of allergy to amide local anesthetics or narcotics
• the presence of a progressive neurological deficit
• history of hepatorenal insufficiency
• the presence of a coagulopathy or infection
• pregnancy
• a history of psychiatric disorder
• inability to follow study protocol

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Sitting Position (head of bed 90 degrees); Ultrasound measurements will be performed. A= skin to the pleura at the level lateral to the subclavian artery, B= skin to center of the subclavian artery, C= skin to first rib, D= skin to "corner pocket"
Semi-sitting position (45 degrees); Ultrasound measurements will be performed. A= skin to the pleura at the level lateral to the subclavian artery, B= skin to center of the subclavian artery, C= skin to first rib, D= skin to "corner pocket"
Supine position; Ultrasound measurements will be performed. A= skin to the pleura at the level lateral to the subclavian artery, B= skin to center of the subclavian artery, C= skin to first rib, D= skin to "corner pocket"

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
patient positioning	Ultrasound measurements will be made at three different positions: Sitting, semi-sitting, and supine. The ultrasound measurements include A= skin to the pleura at the level lateral to the subclavian artery, B= skin to center of the subclavian artery, C= skin to first rib, D= skin to "corner pocket"	Postoperative Day One

Collaborators and Investigators

• Sponsor: Northwestern University

Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Actual): November 1, 2014
• Study Completion (Actual): November 1, 2014

Study Registration Dates

• First Submitted: June 7, 2012
• First Submitted That Met QC Criteria: June 8, 2012
• First Posted (Estimate): June 11, 2012

Study Record Updates

• Last Update Posted (Estimate): March 30, 2015
• Last Update Submitted That Met QC Criteria: March 27, 2015
• Last Verified: March 1, 2015

More Information

Terms related to this study

• Keywords: Supraclavicular Block
• Other Study ID Numbers: STU00058413; Northwestern University (Other Identifier: NU 22I05)