Comparison of Ultrasound-guided Brachial Plexus Blocks and Selective Distal Blocks in Terms of Anesthesia

Comparison of Ultrasound-guided Brachial Plexus Blocks and Selective Distal Blocks in Terms of Anesthesia Success and Discharge Time in Hand and Wrist Surgeries: A Single Center, Historic Cohort Study

Ultrasound-guided brachial plexus blocks (infraclavicular, axillary) can be applied as the main anesthetic method in hand and wrist surgeries, as well as single or combination block applications of the median, radial and ulnar nerves at the forearm level.

Here, we aimed to retrospectively evaluate the perioperative and postoperative data of patients who underwent hand and wrist surgery under distal nerve blocks and brachial plexus blocks in our hospital.

Study Overview

• Status: Completed
• Conditions: Pain, Postoperative; Anesthesia, Local; Patient Satisfaction
• Intervention / Treatment: Other: descriptive

Detailed Description

The retrospective files of patients who used ultrasound guided regional anesthesia techniques as the main anesthetic method in hand and wrist surgeries in our hospital between 01.01.2021 and 01.09.2022 will be examined. Patients over the age of 18 who go to hand and wrist surgery will be included. Patients who have undergone surgical intervention in more than one region in the same session and who have psychiatric disorders that will affect the perception of pain will be excluded from the study. Demographic characteristics, American Society of Anesthesiology (ASA) scores, comorbidity, block performed (distal peripheral nerve block and/or brachial nerve block) and volume applied, block performance time, first analgesia times, surgery times, surgery types, discharge times, additional The existence of the complaint will be recorded. The data obtained by grouping the patients according to the type of anesthesia applied (brachial plexus block and distal nerve blocks) will be subjected to statistical analysis.

• Study Type: Observational
• Enrollment (Actual): 2

Contacts and Locations

Study Locations

• Turkey
  • Ilkadım
    • Samsun, Ilkadım, Turkey, 55100
      • Samsun University

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Probability Sample

Study Population

Patients over the age of 18 who go to hand and wrist surgery will be included.

Description

Inclusion Criteria:

• Patients over the age of 18 who go to hand and wrist surgery will be included.

Exclusion Criteria:

• Patients who have undergone surgical intervention in more than one region in the same session and who have psychiatric disorders that will affect the perception of pain will be excluded from the study.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
group distal nerve block(DNB); Radial, median and ulnar nerve blocks were used alone or in combinations as a method of anesthesia for patients who had undergone hand and wrist surgery.	Other: descriptive; The block performed (distal peripheral nerve block and/or brachial nerve block) and the volume applied, block performance time, first analgesia times, surgery times, surgery types, discharge times, presence of additional complaints will be recorded. The data obtained by grouping the patients according to the type of anesthesia applied (brachial plexus block and distal nerve blocks) will be subjected to statistical analysis.
group brachial plexus block(BPB); Brachial plexus blocks (infraclavicular, axillary etc.) was applied to patients who were going to undergo hand and wrist surgery.	Other: descriptive; The block performed (distal peripheral nerve block and/or brachial nerve block) and the volume applied, block performance time, first analgesia times, surgery times, surgery types, discharge times, presence of additional complaints will be recorded. The data obtained by grouping the patients according to the type of anesthesia applied (brachial plexus block and distal nerve blocks) will be subjected to statistical analysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality in Anaesthesia	The patients were called by phone and asked to evaluate the anesthesia technique used in their surgery. Three main judgments including 'quality of anesthesia', 'whether they would prefer the same anesthesia again' and 'whether they would recommend this technique to others' were evaluated with a 5-point Likert scale. 5 point Likert scale consists of 5 answer options which will contain two extreme poles and a neutral option connected with intermediate answer options. In evaluation of parient satisfaction, we used 5 point Likert scale example to measure satisfaction is: (1) Very dissatisfied, (2)Dissatisfied, (3) Neither satisfied nor dissatisfied, (4) Satisfied , (5)Very satisfied . In other terms, (1) Strongly disagree; (2) Disagree; (3) Neither agree nor disagree; (4) Agree; (5) Strongly agree.	up 24 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
discharge time	The time of discharge will be specified in both groups.	up to 24 hours
block performance time	Block performance time was defined as the time from ultrasound probe insertion to needle removal at the end of perineural injections.	intraoperative
additional anesthetic/analgesic requirement	additional analgesic requirement will be evaluated intraoperatively or postoperatively.	perioperative period
complications	The presence of complications will be evaluated during and after the block.	up to 24 hours

Collaborators and Investigators

• Sponsor: Samsun University
• Investigators: Principal Investigator: gamze MD ertaş, specialist, Samsun University

Publications and helpful links

General Publications

• Soberon JR Jr, Crookshank JW 3rd, Nossaman BD, Elliott CE, Sisco-Wise LE, Duncan SF. Distal Peripheral Nerve Blocks in the Forearm as an Alternative to Proximal Brachial Plexus Blockade in Patients Undergoing Hand Surgery: A Prospective and Randomized Pilot Study. J Hand Surg Am. 2016 Oct;41(10):969-977. doi: 10.1016/j.jhsa.2016.07.092. Epub 2016 Aug 11.
• Ince I, Aksoy M, Celik M. Can We Perform Distal Nerve Block Instead of Brachial Plexus Nerve Block Under Ultrasound Guidance for Hand Surgery? Eurasian J Med. 2016 Oct;48(3):167-171. doi: 10.5152/eurasianjmed.2016.0256.

Study record dates

Study Major Dates

• Study Start (Actual): December 20, 2022
• Primary Completion (Actual): December 29, 2022
• Study Completion (Actual): December 29, 2022

Study Registration Dates

• First Submitted: November 21, 2022
• First Submitted That Met QC Criteria: December 12, 2022
• First Posted (Actual): December 19, 2022

Study Record Updates

• Last Update Posted (Actual): December 30, 2022
• Last Update Submitted That Met QC Criteria: December 29, 2022
• Last Verified: December 1, 2022

More Information

Terms related to this study

• Keywords: distal nerve block,patient satisfaction,hand surgery
• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Pain, Postoperative
• Other Study ID Numbers: distal block

Drug and device information, study documents

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