A Randomized Comparison Between 0.67 mcg/kg, 1 mcg/kg, and 1.33 mcg/kg of Perineural Dexmedetomidine for Ultrasound-Guided Infraclavicular Block

NCT ID: NCT07249827

Last Updated: 2026-01-07

Study Results

Results pending

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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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

69 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-28

Study Completion Date

2026-06-30

Brief Summary

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This study will compare three different doses of perineural dexmedetomidine 0.67 mcg/kg, 1 mcg/kg, and 1.33 mcg/kg as adjuvants to local anesthetics for ultrasound-guided infraclavicular brachial plexus blocks (ICBs). Our research hypothesis is that 1.33 mcg/kg will provide a 15%-longer duration than 1mcg/kg, which in turn will provide a 15%-longer duration than 0.67 mcg/kg. Since analgesic duration and sensory duration can be influenced by intake of pain medications and surgical trauma to small cutaneous nerves, respectively, we will select motor block duration as the main outcome to better target the action of dexmedetomidine on the brachial plexus.

Detailed Description

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With the approval of Ethics Committee of the McGill University Health Centre, a total of 69 patients undergoing upper extremity surgery (elbow and below) will be recruited. Recruitment will be carried out by an investigator not involved in patient care one day before surgery

All ICBs will be supervised by the coauthors and conducted preoperatively in an induction room.

After skin disinfection and draping, the ICB will be performed with a previously described technique. In each group, a proven 90% effective volume of 35 mL of local anesthetic solution will be injected. As LA solution, it will be used a mixture of lidocaine 1.0%-bupivacaine 0.25% with epinephrine 5 µ/mL plus PN 2 mg dexamethasone. The injectate will be slowly injected through the block needle.

Patients will be randomized to receive the study drug, PN dexmedetomidine 0.67 mcg/kg or PN dexmedetomidine 1 mcg/kg, or PN dexmedetomidine 1.33 mcg/kg mixed with the above-mentioned LA solution.

A research assistant (licensed anesthesiologist) will prepare the local anesthetic solutions and will add the study drug following the randomization order. The operator, patient, and investigator assessing the block will be blinded to group allocation.

The primary outcome will be the duration of the motor block (defined as the temporal interval between the end of LA injection through the block needle and the return of movement to the hand and fingers) for patients with successful ICBs. Patients will be provided with a data sheet and asked to record the time at which motor function returns. An investigator blinded to group allocation will collect this data sheet in person (inpatients) or by phone (outpatients) on postoperative day 1.

Conditions

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Analgesia Pain, Acute Upper Extremity Surgery Nerve Block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

blinded-randomized controlled trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
A research assistant (licensed anesthesiologist) will prepare the local anesthetic solutions and will add the study drug following the randomization order. The operator, patient and investigator assessing the block will be blinded to group allocation.

Study Groups

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0.67 mcg/kg

Addition of dexmedetomidine 0.67 mcg/kg to local anesthetics in infraclavicular brachial plexus block

Group Type EXPERIMENTAL

dexmedetomidine (perineural) 0.67 mcg/kg

Intervention Type DRUG

Perineural dexmedetomidine 0.67 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

1 mcg/kg

Addition of dexmedetomidine 1 mcg/kg to local anesthetics in infraclavicular brachial plexus block

Group Type EXPERIMENTAL

dexmedetomidine (perineural) 1 mcg/kg

Intervention Type DRUG

Perineural dexmedetomidine 1 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

1.33 mcg/kg

Addition of dexmedetomidine 1.33 mcg/kg to local anesthetics in infraclavicular brachial plexus block

Group Type EXPERIMENTAL

dexmedetomidine (perineural) 1.33 mcg/kg

Intervention Type DRUG

Perineural dexmedetomidine 1.33 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

Interventions

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dexmedetomidine (perineural) 0.67 mcg/kg

Perineural dexmedetomidine 0.67 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

Intervention Type DRUG

dexmedetomidine (perineural) 1 mcg/kg

Perineural dexmedetomidine 1 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

Intervention Type DRUG

dexmedetomidine (perineural) 1.33 mcg/kg

Perineural dexmedetomidine 1.33 mcg/kg will be added to the local anesthetic used to block the cords of the brachial plexus with an infraclavicular approach.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* patients undergoing upper limb surgery at or below the elbow
* age between 18 and 75 years
* American Society of Anesthesiologists classification 1-3
* body mass index between 18 and 35 kg/m2

Exclusion Criteria

* adults who are unable to give their own consent
* allergy or contraindication to dexmedetomidine
* exposure to dexmedetomidine during the previous 48 hrs
* pre-existing neuropathy (assessed by history and physical examination)
* coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood workup i.e. platelets ≤ 100, International Normalized Ratio ≥ 1.4 or partial prothrombin time ≥ 50)
* renal failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work-up i.e. creatinine. eGFR \< 90)
* hepatic failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work-up i.e. transaminases ≥ 100)
* allergy to LA
* pregnancy (as institutional policy, female patients with childbearing potential undergoing non urgent surgery are tested preoperatively for pregnancy with blood tests)
* breast feeding
* prior surgery in the infraclavicular region
* chronic pain syndromes requiring opioid intake at home
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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McGill University Health Centre/Research Institute of the McGill University Health Centre

OTHER

Sponsor Role lead

Responsible Party

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Julián Aliste

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Julián Aliste, MD

Role: PRINCIPAL_INVESTIGATOR

McGill University Health Centre/Research Institute of the McGill University Health Centre

Locations

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McGill University Health Centre

Montreal, Quebec, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Julián Aliste, MD

Role: CONTACT

514-934-1934 ext. 43261

Facility Contacts

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Samita Pirotesak, M.D.

Role: primary

4384067337

References

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Other Identifiers

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2025-11084

Identifier Type: -

Identifier Source: org_study_id

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