Ultrasound-Guided Axillary or Infraclavicular Nerve Block for Upper Limb Surgery
NCT ID: NCT00724035
Last Updated: 2009-07-15
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
PHASE4
52 participants
INTERVENTIONAL
2008-05-31
2009-07-31
Brief Summary
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Using ultrasound guidance, axillary (i.e., at the armpit) and infraclavicular (i.e., below the collarbone) blocks will be performed to patients undergoing upper limb surgery.
The investigators will analyze how long it takes for anesthesia to be adequate for pain-free surgery, thus determine the optimal technique for this kind of surgery.
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Detailed Description
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A reference block for upper limb surgery thanks to its safety profile and clinical efficacy, the axillary approach may be more painful or unpleasant for some patients.
The investigators aim to determine possible differences in onset time and patient acceptance between the two techniques.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Infraclavicular
This group will receive an ultrasound-guided infraclavicular brachial plexus block.
Midazolam
Procedural sedation before the execution of the block.
* 0.03 mg/kg iv bolus
Ropivacaine
0.75% (wt/vol) solution, 20 ml perineural injection
Fentanyl
50 µg iv bolus prn for pain during surgery, up to 150 µg
General anesthesia
General anesthesia will be induced if pain during surgery develops which is intractable with iv fentanyl ≤150 µg.
Infraclavicular brachial plexus block
Blocks will be performed under high-resolution real-time ultrasound guidance.
Patients will be in the supine position. The linear transducer will be initially positioned between the middle and lateral third of the clavicle, scanning on a parasagittal plane.
The axillary artery and veins will then be sought for. We will try to visualize the three cords of the brachial plexus separately, and to inject local anesthetic around each of them. If this is not possible, the needle will be positioned cranially and posteriorly to the artery, and the injection will be made from there. A 20 G, 17°-bevel needle will be used for all blocks.
Axillary
This group will receive an ultrasound-guided axillary brachial plexus block.
Midazolam
Procedural sedation before the execution of the block.
* 0.03 mg/kg iv bolus
Ropivacaine
0.75% (wt/vol) solution, 20 ml perineural injection
Fentanyl
50 µg iv bolus prn for pain during surgery, up to 150 µg
General anesthesia
General anesthesia will be induced if pain during surgery develops which is intractable with iv fentanyl ≤150 µg.
Axillary brachial plexus nerve block
Blocks will be performed under high-resolution real-time ultrasound guidance.
Patients will be in the supine position. With the abducted arm flexed 90° at the elbow, the transducer will scan for the axillary artery in its short-axis. Individual nerves will be sought for around the artery.
A 22G, 17°-bevel needle will be advanced in-plane to inject aliquots of local anesthetic around each nerve structure up to the prescribed dose.
Interventions
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Midazolam
Procedural sedation before the execution of the block.
* 0.03 mg/kg iv bolus
Ropivacaine
0.75% (wt/vol) solution, 20 ml perineural injection
Fentanyl
50 µg iv bolus prn for pain during surgery, up to 150 µg
General anesthesia
General anesthesia will be induced if pain during surgery develops which is intractable with iv fentanyl ≤150 µg.
Axillary brachial plexus nerve block
Blocks will be performed under high-resolution real-time ultrasound guidance.
Patients will be in the supine position. With the abducted arm flexed 90° at the elbow, the transducer will scan for the axillary artery in its short-axis. Individual nerves will be sought for around the artery.
A 22G, 17°-bevel needle will be advanced in-plane to inject aliquots of local anesthetic around each nerve structure up to the prescribed dose.
Infraclavicular brachial plexus block
Blocks will be performed under high-resolution real-time ultrasound guidance.
Patients will be in the supine position. The linear transducer will be initially positioned between the middle and lateral third of the clavicle, scanning on a parasagittal plane.
The axillary artery and veins will then be sought for. We will try to visualize the three cords of the brachial plexus separately, and to inject local anesthetic around each of them. If this is not possible, the needle will be positioned cranially and posteriorly to the artery, and the injection will be made from there. A 20 G, 17°-bevel needle will be used for all blocks.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Scheduled upper extremity orthopedic surgery
Exclusion Criteria
* Allergy to study drugs
* Contraindication to nerve block at the assigned site
18 Years
80 Years
ALL
No
Sponsors
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University of Parma
OTHER
Responsible Party
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University of Parma
Principal Investigators
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Guido Fanelli, MD
Role: STUDY_CHAIR
Section of Anesthesiology and Critical Care, Dept. of Surgical Sciences, University of Parma
Giorgio Danelli, MD
Role: PRINCIPAL_INVESTIGATOR
UO II Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma
Locations
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University Hospital / Azienda Ospedaliero-Universitaria
Parma, PR, Italy
Countries
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Other Identifiers
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ANEST-ORT-02
Identifier Type: -
Identifier Source: org_study_id
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