Intercostobrachial Nerve Block (ICBN) for Tourniquet Pain: Is it Necessary?

University of Florida

Status and phase: Completed; Early Phase 1

Conditions: Nerve Block; Pain

Treatments: Behavioral: No ICBN block; Drug: Receive ICBN with ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT03797924

OCR19802 (Other Identifier)

IRB201802525

Details and patient eligibility

About

In this study the investigators would like to show that when patients undergo upper limb surgery under supraclavicular brachial plexus block, additional blocking of the Intercostobrachial Nerve Block (ICBN) does not affect the incidence or course of tourniquet pain.

Full description

The ICBN is a cutaneous sensory nerve that supplies the medial aspect of the upper arm. Traditionally this nerve is blocked to alleviate tourniquet pain. The etiology of tourniquet pain is complex and the study team hypothesize that blocking the ICBN has no impact on tourniquet pain. Patients will receive a supraclavicular block and be divided into two groups; ICBN with local anesthetic or ICBN with saline. All patients in this study will receive a supraclavicular block as their primary anesthetic and then be divided into two groups; those who receive ICBN and those who do not. Amount of intraoperative analgesics, conversion to deep sedation or general anesthesia, and onset of time to tourniquet pain will be the primary measures of this study.

Enrollment: 46 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) 1-3
• Distal upper extremity surgery with anticipated use of tourniquet
• Outpatient surgery
• Patients who desire regional anesthesia as primary anesthetic

Exclusion criteria

• ASA 4 or greater
• Allergies to local anesthetic
• Refusal of regional anesthesia
• History of chronic pain syndromes
• Patients who do not desire regional anesthesia as primary anesthetic

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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46 participants in 2 patient groups, including a placebo group

ICBN with ropivacaine

Active Comparator group

Description:

Participants will receive ICBN with ropivacaine. In order to blind anesthesia providers in the room and nurses in PACU, the site of injection for ICBN will be prepped with tinted chlorhexidine in all patients.

Treatment:

Drug: Receive ICBN with ropivacaine

No ICBN block

Placebo Comparator group

Description:

Participants will have the site prepped, but no ICBN block given. In order to blind anesthesia providers in the room and nurses in PACU, the site of injection for ICBN will be prepped with tinted chlorhexidine in all patients.

Treatment:

Behavioral: No ICBN block