Comparison of Costoclavicular and Paracoracoid Approaches to Infraclavicular Brachial Plexus Blocks

NCT ID: NCT05260736

Last Updated: 2023-05-06

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 56 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-06-01
• Study Completion Date: 2023-05-02

Brief Summary

Infraclavicular block has taken its place in the literature as a proven technique in the anesthetic management of upper extremity surgeries. Compared to general anesthesia; The prominent advantages of regional anesthesia are that it provides longer perioperative pain control, reduces the incidence of postoperative nausea and vomiting, reduces opioid consumption and reduces the cost of hospitalization. The widespread use of ultrasonography (USG) in the last two decades has facilitated the application of the method and allowed the investigation of different injection methods.

Regional blocks are planned according to the surgery to be performed. For anesthesia of arm, forearm and hand operations; brachial plexus can be blocked in the axillary, infraclavicular, supraclavicular or interscalene region. The infraclavicular technique, on the other hand, is roughly divided into three types: costoclavicular lateral, costoclavicular medial and paracoracoid (Lateral sagittal). The image obtained by placing the ultrasonography probe in the relevant anatomical region serves as a guide for the orientation of the peripheral block needle and performing the intervention by observing the vascular structures in the existing region provides a great advantage in terms of patient safety.

In this study, we aimed to examine 3 different infraclavicular block methods; lateral costoclavicular, medial costoclavicular and lateral sagittal (Paracoracoid) approach, in terms of ease of application and motor/sensory block efficiency. Our hypothesis is that the sensory block will begin in a shorter time with costoclavicular methods compared to the lateral sagittal method. We are also planning to compare performance difficulties (needle maneuver numbers, subjective block exertion, block performance time etc.) for each type of intervention.

Conditions

Anesthesia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Group Costoclavicular Lateral (CL)

Patients anesthetized with costoclavicular lateral infraclavicular brachial plexus block.

Group Type: ACTIVE_COMPARATOR

Infraclavicular brachial plexus block

Intervention Type: PROCEDURE

Named after the anatomical site; patients will be applied infraclavicular brachial plexus block with costoclavicular lateral, costoclavicular medial or lateral sagittal approach.

Group Costoclavicular Medial (CM)

Patients anesthetized with costoclavicular medial infraclavicular brachial plexus block.

Group Type: ACTIVE_COMPARATOR

Infraclavicular brachial plexus block

Intervention Type: PROCEDURE

Named after the anatomical site; patients will be applied infraclavicular brachial plexus block with costoclavicular lateral, costoclavicular medial or lateral sagittal approach.

Group Lateral Sagittal (LS)

Patients anesthetized with lateral sagittal infraclavicular brachial plexus block.

Group Type: ACTIVE_COMPARATOR

Infraclavicular brachial plexus block

Intervention Type: PROCEDURE

Named after the anatomical site; patients will be applied infraclavicular brachial plexus block with costoclavicular lateral, costoclavicular medial or lateral sagittal approach.

Interventions

Infraclavicular brachial plexus block

Named after the anatomical site; patients will be applied infraclavicular brachial plexus block with costoclavicular lateral, costoclavicular medial or lateral sagittal approach.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients scheduled for elective upper extremity surgeries (Arm, upper-arm and hand)

Exclusion Criteria

• Patients with bleeding diathesis Presence of infection on the intervention site Patients requiring continous anticoagulation therapy due to the existing comorbidities Patients with history of local anesthetic allergy Pregnant patients

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Istanbul University

OTHER

Sponsor Role: lead

Responsible Party

Meltem Savran Karadeniz

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Meltem Savran Karadeniz

Istanbul, Fatih, Turkey (Türkiye)

Countries

Turkey (Türkiye)

References

Bingul ES, Canbaz M, Guzel M, Salviz EA, Akalin BE, Berkoz O, Emre Demirel E, Sungur Z, Savran Karadeniz M. Comparing the clinical features of lateral and medial approaches of costoclavicular technique versus traditional lateral sagittal technique as infraclavicular brachial plexus block methods: a randomized controlled trial. BMC Anesthesiol. 2024 Jul 25;24(1):254. doi: 10.1186/s12871-024-02645-z.

Reference Type: DERIVED

PMID: 39054425 (View on PubMed)

Other Identifiers

2022/151

Identifier Type: -

Identifier Source: org_study_id