Brachial Plexus Block vs General Anesthesia in Upper Extremity Surgery

Comparison of Brachial Plexus Block Versus General Anesthesia for Upper Extremity Surgery: A Randomized Controlled Trial

This study compares two different anesthesia methods for upper arm and hand surgery: regional anesthesia (brachial plexus block) versus general anesthesia.

Regional anesthesia numbs only the arm being operated on by injecting local anesthetic near the nerves, while the patient remains awake or lightly sedated. General anesthesia puts the patient completely asleep using medications given through a breathing tube.

The main goals of this study are to compare:

• How much pain patients experience after surgery
• Patient satisfaction with their anesthesia
• Side effects such as nausea, vomiting, or breathing problems
• Time until patients are ready to go home
• Overall safety of each method

Participants in this study will be randomly assigned to receive either brachial plexus block or general anesthesia for their scheduled upper extremity surgery. The research team will monitor participants during surgery and follow their recovery for 24 hours after the operation.

This research will help doctors and patients make better-informed decisions about which type of anesthesia may be best for upper extremity procedures.

Study Overview

• Status: Completed
• Conditions: Regional Anesthesia; Upper Extremity Surgery; General Anesthetic
• Intervention / Treatment: Procedure: Brachial Plexus Block; Procedure: General Anesthesia

• Study Type: Interventional
• Enrollment (Actual): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Adana
    • Adana, Adana, Turkey (Türkiye), 01150
      • Adana City Training and Research Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• clusion Criteria:
• Adults aged 18-65 years
• ASA physical status I-II
• Scheduled for elective upper-extremity orthopedic surgery
• Able to provide informed consent
• Able to understand and complete study questionnaires

Exclusion Criteria:

• Contraindications to regional anesthesia
• Coagulopathy or bleeding disorders
• Local infection at the block site
• Patient refusal of regional anesthesia
• Known allergy to local anesthetic agents
• Chronic opioid use (daily use for >3 months)
• Psychiatric disorders preventing cooperation or consent
• Pregnancy or breastfeeding
• Severe respiratory disease (for general anesthesia group)
• Pre-existing neurological deficit in the operative extremity
• Emergency surgery
• ASA physical status III or higher

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Brachial Plexus Block Group; Patients receiving ultrasound-guided brachial plexus block for upper extremity surgery	Procedure: Brachial Plexus Block; Ultrasound-guided infraclavicular brachial plexus block using local anesthetic (e.g., ropivacaine or bupivacaine). Block performed before surgery to provide regional anesthesia for upper extremity surgery.
Active Comparator: General Anesthesia Group; Patients receiving general anesthesia for upper extremity surgery	Procedure: General Anesthesia; Standard general anesthesia with intravenous induction and maintenance with volatile anesthetics or total intravenous anesthesia (TIVA). Endotracheal intubation or laryngeal mask airway used as appropriate.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Preoperative Anxiety Score	Preoperative anxiety measured immediately prior to operating room entry using the State-Trait Anxiety Inventory-State (STAI-S) scale. STAI-S is a validated 20-item questionnaire assessing current state anxiety. Scores range from 20 to 80, with higher scores indicating greater anxiety levels.	Immediately before operating room entry (preoperatively)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Pain Score	Pain intensity measured using Visual Analog Scale (VAS) at multiple time points after surgery. VAS scores range from 0 to 10, where 0 indicates no pain and 10 indicates worst pain imaginable. Lower scores indicate better outcome.	From end of surgery to 24 hours postoperatively
Opioid Consumption	Total opioid consumption measured as morphine equivalent dose (mg) during the postoperative period. All opioid medications administered were converted to morphine equivalents using standard conversion factors. Lower consumption indicates better outcome.	From end of surgery to 24 hours postoperatively
Number of Participants with Postoperative Nausea and Vomiting (PONV)	Number of participants experiencing postoperative nausea and/or vomiting requiring antiemetic treatment during the postoperative period. PONV was defined as any episode of nausea or vomiting reported by the patient or requiring rescue antiemetic medication.	First 24 hours postoperatively
PACU Length of Stay	Duration of stay in the Post-Anesthesia Care Unit (PACU) measured in minutes, from admission to discharge readiness based on standardized discharge criteria (Aldrete score ≥9). Shorter stay indicates better recovery.	From PACU admission until discharge readiness (typically 0-4 hours postoperatively
Quality of Recovery (QoR-15) Score	Patient-reported quality of recovery assessed using the validated Quality of Recovery-15 (QoR-15) questionnaire. QoR-15 is a 15-item instrument measuring five dimensions of recovery: physical comfort, emotional state, psychological support, physical independence, and pain. Each item is scored 0-10, with total scores ranging from 0 to 150. Higher scores indicate better quality of recovery.	24 hours postoperatively
Patient Satisfaction Score	Overall patient satisfaction with anesthesia care measured using a numerical rating scale from 0 to 5, where 0 indicates completely dissatisfied and 5 indicates completely satisfied. Patients were asked to rate their overall satisfaction with the anesthesia experience.	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Adana City Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): May 9, 2025
• Primary Completion (Actual): November 3, 2025
• Study Completion (Actual): November 4, 2025

Study Registration Dates

• First Submitted: December 30, 2025
• First Submitted That Met QC Criteria: January 13, 2026
• First Posted (Actual): January 20, 2026

Study Record Updates

• Last Update Posted (Actual): January 20, 2026
• Last Update Submitted That Met QC Criteria: January 13, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Anesthesia and Analgesia; Anesthesia, Conduction; Anesthesia; Nerve Block; Anesthesia, General; Brachial Plexus Block
• Other Study ID Numbers: 536

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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