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Medial Versus Lateral Approach in Ultrasound (US)-Guided Supraclavicular Block

University Health Network, Toronto logo

University Health Network, Toronto

Status

Completed

Conditions

Hand or Arm Surgery

Treatments

Procedure: Media-to-Lateral Approach
Procedure: Lateral-to-Medial Approach

Study type

Interventional

Funder types

Other

Identifiers

NCT00992810
09-0451-B

Details and patient eligibility

About

The ultrasound guided supraclavicular block is a peripheral nerve block which is considered safe, has a fast onset, is dense and provides complete block of the nerves supplying the hand, forearm and arm. However retrospective studies done at Toronto Western Hospital have highlighted the fact that most commonly the ulnar nerve fibres (responsible for sensations in the ring finger, little finger and the corresponding part of hand), sometimes escape this block and need additional supplementary block at a distal peripheral nerve site. It is a confusing fact since all nerve fibres are compactly arranged in a sheath at the supraclavicular level. The local anaesthetic agent at this level should be equally distributed among all nerve fibres. The purpose of this study is to compare two different approaches (medial and lateral) adopted by our clinicians to perform this block and to test the effectiveness of each approach for successful ulnar nerve fibre blockade.

Enrollment

78 patients

Sex

All

Ages

18 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Adult patients presenting for upper limb surgery, excluding shoulder surgery
  • Age 18-80 yrs
  • BMI < 35
  • ASA I - III
  • Consent for the study

Exclusion criteria

  • Pre-existing sensory or motor neurodeficit.
  • Sensitivity to local anaesthetic agents.
  • Patients on anticoagulants or antiplatelet medications (Minidose Aspirin is acceptable) with abnormal coagulation profile.
  • Compromised pulmonary reserve due to COPD, Kypho-scoliosis or Restricted lung disease.
  • Infection or any obvious pathology at the site of block performance
  • History of drug abuse.
  • Psychiatric disease or any condition that precludes an informed consent.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

78 participants in 2 patient groups

Lateral-to-Medial Approach
Experimental group
Description:
Needle approach to the brachial plexus nerves will be made using a lateral-to-medial direction.
Treatment:
Procedure: Lateral-to-Medial Approach
Medial-to-Lateral Approach
Experimental group
Description:
Needle approach to the brachial plexus nerves will be made using a lateral-to-medial direction.
Treatment:
Procedure: Media-to-Lateral Approach

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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