Comparative Study Between Two Different Approaches of Brachial Plexus Block: Supraclavicular Approach and Retroclavicular Approach

In this study investigators will compare two different approaches of brachial plexus block ;supraclavicular approach and retroclavicular approach regarding success rate, duration of block, complications

Study Overview

• Status: Completed
• Conditions: Brachial Plexus Block
• Intervention / Treatment: Procedure: supraclavicular brachial plexus block; Procedure: Retroclavicular brachial plexus block

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Sohag, Egypt
    • Sohag University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 100 patients doing distal arm surgery, elective , 18 to 60 years old , will be included in double blinded randomized study.

Exclusion Criteria:

• Patient refusal .
• local infection or deformity at the block site.
• Patient with significant neurological , psychiatric or neuromuscular disease.
• Pregnancy or lactating women .
• Coagulopathy .
• Morbid obesity .
• History of allergy to local anaesthetics

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Supraclavicular approach group; probe placed firmly over the supraclavicular fossa, parallel to the clavicle to obtain a short-axis view of the divisions of the brachial plexus and the subclavian artery, lying on the first rib After skin infiltration with lidocaine 2% a 23-gauge 70mm block needle inserted in-plane with the ultrasound beam, in a lateral-to-medial direction, until the needle tip's positioned at the junction of the first rib and subclavian artery	Procedure: supraclavicular brachial plexus block; group will receive brachial plexus block above clavicle,Injection of anaesthetic will be done in brachial plexus around subclavian artery
Active Comparator: Retroclavicular approach group; the probe will be placed below and perpendicular to the clavicle, in a paramedian sagittal plane, medial to the coracoid process, to obtain a short-axis view of the cords of the brachial plexus and the axillary vessels. The needle will be then inserted in the supraclavicular fossa, approximately 1 cm posteriorly to the clavicle, and advanced in plane and strictly parallel to the ultrasound transducer. After passing the initial blind zone of about 2 cm caused by the acoustic shadow of the clavicle, the needle tip is constantly seen, until it is positioned posterior to the axillary artery	Procedure: Retroclavicular brachial plexus block; group will receive brachial plexus block inferior to the clavicle,injection of anaesthetic will be done around axillary artery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Block success rate	Investigator will compare success rate of both types of block and which one is more likely to be successfully administrated	one year
Complications	Investigators will compare complications like pneumothorax,nerve injury,bleeding and which one is more likely to cause complications	one year
Duration of sensory and motor blockade	Time which each procedure will take to block sensory and motor stimuli	one year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Duration of procedure	Time which took the investigator to administrate each type of block	one year
Number of needle passes	number of times in which needle has entered been entered into the participant in each group	one year

Collaborators and Investigators

• Sponsor: Sohag University

Publications and helpful links

General Publications

• Albrecht E, Mermoud J, Fournier N, Kern C, Kirkham KR. A systematic review of ultrasound-guided methods for brachial plexus blockade. Anaesthesia. 2016 Feb;71(2):213-27. doi: 10.1111/anae.13347. Epub 2015 Dec 16.
• Grape S, Pawa A, Weber E, Albrecht E. Retroclavicular vs supraclavicular brachial plexus block for distal upper limb surgery: a randomised, controlled, single-blinded trial. Br J Anaesth. 2019 Apr;122(4):518-524. doi: 10.1016/j.bja.2018.12.022. Epub 2019 Jan 31.
• Charbonneau J, Frechette Y, Sansoucy Y, Echave P. The Ultrasound-Guided Retroclavicular Block: A Prospective Feasibility Study. Reg Anesth Pain Med. 2015 Sep-Oct;40(5):605-9. doi: 10.1097/AAP.0000000000000284.
• Yazer MS, Finlayson RJ, Tran DQ. A randomized comparison between infraclavicular block and targeted intracluster injection supraclavicular block. Reg Anesth Pain Med. 2015 Jan-Feb;40(1):11-5. doi: 10.1097/AAP.0000000000000193.

Study record dates

Study Major Dates

• Study Start (Actual): January 5, 2022
• Primary Completion (Actual): September 5, 2022
• Study Completion (Actual): September 5, 2022

Study Registration Dates

• First Submitted: November 28, 2021
• First Submitted That Met QC Criteria: January 7, 2022
• First Posted (Actual): January 12, 2022

Study Record Updates

• Last Update Posted (Actual): September 8, 2022
• Last Update Submitted That Met QC Criteria: September 4, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: Soh-Med-21-11-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No