Classic Versus Interfascial Axillary Block in Hand, Wrist, and Forearm Surgery
Comparison of Axillary Block and Interfascial Axillary Block in Terms of Block Success and Intraoperative Clinical Efficacy in Hand, Wrist, and Forearm Surgery: A Prospective Randomized Study
Hand, wrist, and forearm surgeries are commonly performed procedures with significant postoperative pain potential. Regional anesthesia of the brachial plexus via the axillary approach is one of the gold-standard techniques for distal upper-limb surgery. In the conventional (classic) axillary block, the median, ulnar, and radial nerves within the axillary sheath are individually targeted under ultrasound guidance; however, anatomical septations around the axillary artery may prevent homogeneous spread of local anesthetic, leading to a patchy block and reduced intraoperative success.
The interfascial axillary block is a modified approach in which local anesthetic is deposited into the fascial planes between the axillary muscles rather than directly into the nerve sheath, aiming for passive diffusion, homogeneous spread, and fewer needle manipulations. This prospective, randomized, single-center study compares the classic axillary block with the interfascial axillary block in patients undergoing hand, wrist, and forearm surgery, primarily in terms of surgical anesthesia adequacy (block success).
調査の概要
詳細な説明
This is a prospective, randomized, single-center clinical trial conducted in a Department of Anesthesiology and Reanimation. Randomization is performed using the sealed-envelope method. A total of 110 patients (55 per group) aged 18-90 years, American society of anesthesiologists physical status I-III, scheduled for elective hand, wrist, or forearm surgery under ultrasound-guided regional anesthesia will be enrolled.
Group 1 (Classic Axillary Block) receives an ultrasound-guided block targeting the median, ulnar, and radial nerves perineurally/perivascularly within the axillary sheath. Group 2 (Interfascial Axillary Block) receives an ultrasound-guided injection of local anesthetic into the potential fascial planes between the axillary muscles, relying on passive diffusion.
The primary outcome is surgical anesthesia adequacy (block success). Secondary outcomes include block application time, sensory and motor block onset, rates of additional local infiltration and conversion to general anesthesia, intraoperative additional analgesic/sedation requirements, hemodynamic parameters, patient and surgeon satisfaction, and complications.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Korgün Ökmen, PhD.
- 電話番号：05057081021
- メール：korgunokmen@gmail.com
研究場所
-
-
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Bursa、トルコ（Türkiye）、16110
- Bursa Yuksek Ihtisas Training and Research Hospital
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Aged 18-90 years
- American society of anesthesiologists physical status I-II-III
- Scheduled for elective hand, wrist, or forearm surgery
- Written informed consent obtained
Exclusion Criteria:
- History of local anesthetic allergy
- Coagulation disorder
- BMI > 40 kg/m²
- Infection at the block site
- Chronic pain syndrome
- Pregnancy
- Inability to communicate
- Need for emergency surgery
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ：Classic Axillary Block
Ultrasound-guided classic axillary brachial plexus block.
The median, ulnar, and radial nerves within the axillary sheath around the axillary artery are targeted individually by perineural/perivascular injection of local anesthetic.
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Classic (perivascular/perineural) axillary brachial plexus block
|
|
アクティブコンパレータ：Interfascial Axillary Block
Ultrasound-guided interfascial axillary block.
Local anesthetic is injected into the potential fascial planes between the axillary muscles rather than directly into the nerve sheath, allowing passive diffusion of the drug.
|
Interfascial (fascial-plane) axillary brachial plexus block.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Surgical anesthesia adequacy (block success)
時間枠：30 minutes after block
|
Complete sensory and motor blockade of the surgical field, allowing the operation to be completed without additional local infiltration or conversion to general anesthesia
|
30 minutes after block
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Block application time
時間枠：intraoperative
|
time from needle insertion to withdrawal.
|
intraoperative
|
|
Sensory block onset time
時間枠：5., 10., 15., 30. minutes
|
Pin-Prick test in the median, ulnar, radial, and musculocutaneous dermatomes (0: normal, 1: blunt, 2: no sensation).
|
5., 10., 15., 30. minutes
|
|
Motor block onset time
時間枠：5., 10., 15., 30. minutes
|
5., 10., 15., 30. minutes
|
|
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Intraoperative additional analgesic/sedation consumption
時間枠：intraoperative
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intraoperative
|
|
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Patient and surgeon satisfaction
時間枠：end of surgery
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4-point Likert scale (1: very poor, 4: very good)
|
end of surgery
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- BursaYIEAH-2026-1
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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