Comparative Study of Two Infraclavicular Block Approaches in Forearm Surgery

A Comparative Study of Retroclavicular and Classical Coracoid Infraclavicular Brachial Plexus Blocks Using 0.5% Ropivacaine in Patients Undergoing Forearm Surgery.

It is hypothesized that retro clavicular Infraclavicular brachial plexus block is better than classical coracoid Infraclavicular brachial plexus block in patients undergoing forearm surgery

Study Overview

• Status: Completed
• Conditions: Procedure Time
• Intervention / Treatment: Procedure: Retroclavicular infraclavicular brachial plexus block; Procedure: Classic coracoid infraclavicular brachial plexus block

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Sargodha, Punjab Province, Pakistan, 40100
      • Dr Faisal Masood teaching Hospital Sargodha

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Patients from 18-60 years.
2. Male Patients
3. Elective forearm surgery
4. BMI ≤30kg/m2
5. American Society of Anesthesiologist (ASA) Physical Status ≤III

Exclusion Criteria:

1. History of known allergy or hypersensitivity against study drug.
2. Previous surgery on the same limb

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Retroclavicular approch; Use of 25 ml 0.5% Ropivacaine via Retroclavicular Approach	Procedure: Retroclavicular infraclavicular brachial plexus block; The retro clavicular approach to the Infraclavicular brachial plexus block will be performed by placing probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle insertion point was located in the supraclavicular fossa, just medial to the shoulder at a point sufficiently posterior to the clavicle and medial to the trapezius muscle insertion point on the clavicle. The needle will be inserted immediately above the clavicle in the space between the coracoid process and the clavicle and advanced from cephalad to caudal.
Other: Classic coracoid approch; Classic Coracoid Infraclavicular Block with 25 ml 0.5% Ropivacaine	Procedure: Classic coracoid infraclavicular brachial plexus block; The coracoid approach to the Infraclavicular brachial plexus block will be performed by placing the ultrasound probe parasagittally just medial to the coracoid process and caudal from the clavicle. The needle will be inserted cephalad to the ultrasound probe using an in-plane technique and advanced in a caudal direction toward the posterior aspect of the axillary artery, in the vicinity of the posterior cord of the brachial plexus.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
1 onset of motor block.	Onset of motor block assess using modified bromage scale Score Grade of motor blockade(Modified bromage scale) 0 Normal muscle function with full range of movement of elbow, wrist and fingers . 1 Decreased muscle power so that patient can move fingers and /or wrist only 2. Complete loss of muscle function with no movement in fingers/wrist	Intraoperatively
Onset of sensory Block	Onset of sensory block assess using pin prick method Grade of sensory blockade Score; Feeling sharp pinprick (no block) 0; Blunt sensation on pinprick (partial block 1; No sensation on pinprick (complete block) 2	Intraoperatively l
Block adequate for surgery	Block adequate for surgery when there is no need for local infiltration and general anesthesia	Intraoperatively
Needle Shadow and shaft visibility using 5 point likert scale.	NEEDLE SHADOW VISIBILITY 5-POINT LIKERT SCALE SCORE Needle tip visibility; Very poor; Poor; Fair; Good; Very good 5-POINT LIKERT SCALE SCORE Needle Shaft visibility; None of the shaft visualized; Only a small segment of the shaft visualized; Less than half of the shaft visualized; Almost all of the shaft visualized; The entire shaft visualized	Intraoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rescue anesthesia requirement	Rescue anesthesia given when block is not adequate for surgery such as local infiltration and general anesthesia	Intraoperatively after regional block
Complication	Vascular puncture and pneumothorax	Intraoperatively
Procedure Time	Time from insertion of needle to removal of needle	Intraoperatively

Collaborators and Investigators

• Sponsor: Sargodha Medical College

Study record dates

Study Major Dates

• Study Start (Actual): March 22, 2025
• Primary Completion (Actual): August 23, 2025
• Study Completion (Actual): September 20, 2025

Study Registration Dates

• First Submitted: November 25, 2025
• First Submitted That Met QC Criteria: November 25, 2025
• First Posted (Estimated): December 8, 2025

Study Record Updates

• Last Update Posted (Actual): December 16, 2025
• Last Update Submitted That Met QC Criteria: December 13, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: SMC-ANS-2025-001

Drug and device information, study documents

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