Comparison of Costoclavicular and Lateral Sagittal Infraclavicular Blocks (CCLS-ICB)

Effect of Costoclavicular Versus Lateral Sagittal Infraclavicular Block on Hemidiaphragmatic Function: A Randomized Clinical Study

This randomized clinical study aims to compare the effects of two different ultrasound-guided infraclavicular brachial plexus block techniques-costoclavicular and lateral sagittal approaches-in patients undergoing forearm, wrist, or hand surgery.

The primary objective of the study is to evaluate and compare the incidence of hemidiaphragmatic dysfunction associated with these two block techniques. Secondary outcomes include sensory and motor block characteristics, postoperative pain scores, analgesic requirements, and potential block-related complications.

Eligible adult patients scheduled for elective forearm or hand surgery are randomly assigned to receive either a costoclavicular or a lateral sagittal infraclavicular nerve block using bupivacaine under ultrasound guidance. Standard general anesthesia and postoperative analgesia protocols are applied.

The results of this study are expected to provide evidence on the relative safety and efficacy of these two infraclavicular block approaches, particularly regarding diaphragmatic function, and to help guide anesthesiologists in selecting the most appropriate regional anesthesia technique for upper extremity surgery.

Study Overview

• Status: Completed
• Conditions: Upper Extremity Surgery; Hemidiaphragmatic Paralysis
• Intervention / Treatment: Procedure: Ultrasound-guided Infraclavicular block

• Study Type: Interventional
• Enrollment (Actual): 91
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye), 06560
      • Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Adults aged 18-80 years
• ASA physical status I-III
• Scheduled for forearm, wrist, or hand surgery
• Planned infraclavicular brachial plexus block

Exclusion Criteria:

• Refusal of regional anesthesia
• Known allergy to local anesthetics
• Infection at the block site
• Pre-existing neurological deficit in the operative limb
• Severe pulmonary disease
• Coagulopathy or sepsis
• BMI > 40 kg/m²
• Psychiatric disorders

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Costoclavicular infraclavicular block; Ultrasound-guided costoclavicular infraclavicular brachial plexus block	Procedure: Ultrasound-guided Infraclavicular block; Ultrasound-guided infraclavicular brachial plexus block performed using either the costoclavicular or lateral sagittal approach with standardized local anesthetic volume.; Other Names: costoclavicular infraclavicular block; lateral sagital infraclavicular block
Active Comparator: Lateral sagittal infraclavicular block; Ultrasound-guided lateral sagittal infraclavicular brachial plexus block	Procedure: Ultrasound-guided Infraclavicular block; Ultrasound-guided infraclavicular brachial plexus block performed using either the costoclavicular or lateral sagittal approach with standardized local anesthetic volume.; Other Names: costoclavicular infraclavicular block; lateral sagital infraclavicular block

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Diaphragmatic excursion	Diaphragmatic excursion measured by ultrasound during normal and deep breathing to asses the effect of costoclavicular and lateral sagittal infraclavicular block techniques.	Baseline(pre-block) and 30 minutes after block performance.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensory and motor block onset time	Time from completion of the infraclavicular block to achievement of complete sensory and motor block in the radial, median, ulnar, and musculocutaneous nerve distributions. Sensory and motor function were assessed every 5 minutes for up to 30 minutes after block performance, and block onset time was defined as the time to complete block.	Within the first 30 minutes after block performance.
Time to first postoperative analgesic requirement	Time from the end of the surgery to the first analgesic requirement.	Within the first 24 hours postoperatively.

Collaborators and Investigators

• Sponsor: Gazi University
• Investigators: Principal Investigator: Irfan Güngör, MD, Gazi University Faculty of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): October 15, 2022
• Primary Completion (Actual): April 15, 2023
• Study Completion (Actual): April 15, 2023

Study Registration Dates

• First Submitted: January 28, 2026
• First Submitted That Met QC Criteria: January 28, 2026
• First Posted (Actual): February 4, 2026

Study Record Updates

• Last Update Posted (Actual): February 5, 2026
• Last Update Submitted That Met QC Criteria: February 3, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Infraclavicular brachial plexus block; hemidiaphragmatic paralysis; costoclavicular brachial plexus block
• Other Study ID Numbers: ICB-CC-LS-2022

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