Comparative Study of Subcoracoid Tunnel Block Versus Costoclavicular Block

NCT ID: NCT07305584

Last Updated: 2025-12-26

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-01
• Study Completion Date: 2026-04-01

Brief Summary

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following the ultrasound-guided subcoracoid tunnel block or costoclavicular block for elderly patients undergoing distal upper limb surgeries.

Conditions

Distal Upper Limb Surgeries

Keywords

elderly Patients distal Upper Limb SurgeriesSubcoracoid Tunnel Block Costoclavicular Block

Study Design

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

Study Groups

Group (S)

The patient will receive subcoracoid tunnel block

Group Type: ACTIVE_COMPARATOR

subcoracoid tunnel block

Intervention Type: OTHER

The probe will be placed with its proximal end towards the mid-clavicular point and distal end with a marker towards the apex of the axilla. A medial tilt of the probe will demonstrate the posterior and medial cords, while a slight lateral tilt of the probe will demonstrate the lateral cord. The needle entry point at the distal end of the probe will be marked. By using the in-plane technique, the needle will be advanced from a caudal to cephalad direction. The probe will be tilted medially, and the needle will be advanced to position its tip above the posterior or medial cord. The probe will be tilted laterally. The needle tip will be repositioned above the lateral cord, and the LA will be injected

Group (C)

The patient will receive costoclavicular block

Group Type: ACTIVE_COMPARATOR

Costoclavicular block

Intervention Type: OTHER

. The key anatomical structures will be identified under ultrasound: the pectoralis major muscle, subclavius muscle, and three brachial plexus cords (lateral, medial, and posterior) clustered tightly lateral to the axillary artery, along with the axillary artery and vein. The needle will be inserted by the in-plane technique from lateral to medial. The needle tip will be advanced through subcutaneous tissue and subclavius, aiming to land in the costoclavicular fascial plane between the cords, ideally between the lateral and posterior cords and superficial to the medial cord, without traversing neural structure by multipoint strategy, and local anesthesia will be injected.

Interventions

subcoracoid tunnel block

The probe will be placed with its proximal end towards the mid-clavicular point and distal end with a marker towards the apex of the axilla. A medial tilt of the probe will demonstrate the posterior and medial cords, while a slight lateral tilt of the probe will demonstrate the lateral cord. The needle entry point at the distal end of the probe will be marked. By using the in-plane technique, the needle will be advanced from a caudal to cephalad direction. The probe will be tilted medially, and the needle will be advanced to position its tip above the posterior or medial cord. The probe will be tilted laterally. The needle tip will be repositioned above the lateral cord, and the LA will be injected

Intervention Type: OTHER

Costoclavicular block

. The key anatomical structures will be identified under ultrasound: the pectoralis major muscle, subclavius muscle, and three brachial plexus cords (lateral, medial, and posterior) clustered tightly lateral to the axillary artery, along with the axillary artery and vein. The needle will be inserted by the in-plane technique from lateral to medial. The needle tip will be advanced through subcutaneous tissue and subclavius, aiming to land in the costoclavicular fascial plane between the cords, ideally between the lateral and posterior cords and superficial to the medial cord, without traversing neural structure by multipoint strategy, and local anesthesia will be injected.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients acceptance to share in the study.
• Patients with ASA physical status I-II.
• Patients with a body mass index (BMI): of 18.5-30 kg/m2.
• Patients undergoing distal upper limb surgeries not more than 2 hours.

Exclusion Criteria

• Patients with a history of allergic reactions or contraindications to local anesthetics.
• Patients with significant comorbidities (e.g., severe cardiovascular, neurological, or musculoskeletal disorders).
• Patients with respiratory insufficiency.
• Patients with coagulation disorders or taking drugs affecting surgical hemostasis.
• Patients with pre-existing neurological deficits

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 85 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Zagazig University

OTHER_GOV

Sponsor Role: lead

Responsible Party

Marwa Mohamed Medhat

assistant professor of anesthesia and surgical intensive care(Principal Investigator)

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Howida A Kamal, MD

Role: STUDY_DIRECTOR

faculty of medicine,zagazig university Egypt

Locations

faculty of medicine,zagazig university Egypt

Zagazig, , Egypt

Countries

Egypt

Central Contacts

Marwa M Medhat, MD

Role: CONTACT

Phone: 01002828937

Email: medhatmarwa9@gmail.com

Howida A Kamal, MD

Role: CONTACT

Phone: 01225096755

Email: K.Howida@yahoO.com

Facility Contacts

Marwa M Medhat, MD

Role: primary

References

Kaya S, Sahap M, Demirtas K. Comparison of costoclavicular and lateral sagittal infraclavicular approaches in ultrasound-guided brachial plexus block. Agri. 2025 Jan;37(1):32-41. doi: 10.14744/agri.2024.34022.

Reference Type: BACKGROUND

PMID: 39835953 (View on PubMed)

Other Identifiers

ZU-IRB#1885/7-Nov-2025

Identifier Type: -

Identifier Source: org_study_id