Comparison of Conventional and Retroclavicular Approaches for Ultrasound-guided Infraclavicular Brachial Plexus Block

Comparison of Conventional and Retroclavicular Approaches for Ultrasound-guided Infraclavicular Brachial Plexus Block in Obese Patients

Forearm and hand surgeries are among the most frequently performed surgical interventions both in trauma patients and electively.In these procedures, alternative anesthesia methods such as general anesthesia, regional intravenous anesthesia, regional peripheral nerve blocks and local anesthesia are available.

Peripheral nerve blockade can be used for anesthesia and analgesia.This method allows patients to undergo surgery without general anesthesia and increases patient satisfaction by providing effective analgesia in the postoperative period.

The aim of this study was to compare the conventional and retroclavicular approaches to infraclavicular block in patients undergoing forearm and hand surgery.

Study Overview

• Status: Recruiting
• Conditions: Pain Management; Peripheral Nerve Block; Hand Surgery; Upper Extremity; Forearm Surgery
• Intervention / Treatment: Procedure: Conventional approach to infraclavicular block; Procedure: Retroclavicular approach to the infraclavicular block

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Musa Zengin, Associate Professor; Phone Number: +905307716235; Email: musazengin@gmail.com
• Study Contact Backup: Name: Ibrahim Topcu, MD; Phone Number: +905437860316; Email: ibrahimtpc78@gmail.com

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Yenimahalle, Ankara, Turkey (Türkiye), 06170
      • Recruiting
      • Ankara Etlik City Hospital
      • Contact: İbrahim Topcu, MD; Phone Number: 00905437860316; Email: ibrahimtpc78@gmail.com
      • Contact: Musa Zengin, Associate Professor; Phone Number: 00905307716235; Email: musazengin@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients 18-80 years of age
• Those with ASA score II-III
• Those with a body mass index (BMI) >30
• Patients who are suitable for forearm and hand surgery under regional anesthesia in the operating room

Exclusion Criteria:

• Patients who cannot perceive and evaluate pain
• Patients who want to have surgery under general anesthesia
• Patients in whom regional anesthesia is contraindicated

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional approach to infraclavicular block; After the patients are monitored and placed in the supine position, after appropriate field sterilization, Conventional approach to infraclavicular block will be performed on the patients using 25 ml of local anesthetic solution (20 ml 0.5% bupivacaine + 5 ml 2% lidocaine) under ultrasound guidance.	Procedure: Conventional approach to infraclavicular block; Conventional approach to infraclavicular block will be performed on the patients using 20 ml of 0.5% bupivacaine 5ml of %2 lidocaine under ultrasound guidance.
Active Comparator: Retroclavicular approach to the infraclavicular block; After the patients are monitored and placed in the supine position, after appropriate field sterilization, Retroclavicular approach to the infraclavicular block will be performed on the patients using 25 ml of local anesthetic solution (20 ml 0.5% bupivacaine + 5 ml 2% lidocaine) under ultrasound guidance.	Procedure: Retroclavicular approach to the infraclavicular block; Retroclavicular approach to the infraclavicular block will be performed on the patients using 20 ml of 0.5% bupivacaine 5ml of %2 lidocaine under ultrasound guidance.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Block Performance Time	Total block performance time (from skin puncture to needle removal) will be recorded	During regional anesthesia

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Score	Pain will be assessed using a visual analog scale from 0 mm (no pain) to 100 mm (worst pain) at rest and when coughing. Pain assessment will be made at 0, 1, 6, 12, 18, and 24 hours after surgery.	Up to 24 hours
Patient Satisfaction	Quality of recovery-15 (QoR-15) score was used as the satisfaction score. The patient-reported Turkish QoR-15 score includes 15 questions that evaluate the patient's postoperative recovery. The QoR-15 score is grouped under two groups, A and B. A high QoR-15 score, a score between 0 (poor) and 10 (excellent) for each item, and a total score of 150 indicate better quality of recovery.	1 day

Collaborators and Investigators

• Sponsor: Ankara Etlik City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 15, 2025
• Primary Completion (Estimated): June 5, 2026
• Study Completion (Estimated): June 25, 2026

Study Registration Dates

• First Submitted: February 13, 2025
• First Submitted That Met QC Criteria: August 29, 2025
• First Posted (Estimated): September 3, 2025

Study Record Updates

• Last Update Posted (Actual): December 15, 2025
• Last Update Submitted That Met QC Criteria: December 8, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Obesity; Upper Extremity; Hand surgery; Forearm surgery; Infraclavicular Block
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Nutrition Disorders; Overnutrition; Body Weight; Neurobehavioral Manifestations; Overweight; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Nutritional and Metabolic Diseases; Signs and Symptoms; Obesity; Agnosia
• Other Study ID Numbers: AEŞH-EK-2025-006

Drug and device information, study documents

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