Periarterial Injection Versus Multiple Periveural Injection

North American Institute for Continuing Medical Education (NAICE)

Status: Completed

Conditions: Crush Injury Wrist or Hand; Contusion Wrist or Hand

Treatments: Procedure: US-guided periarterial techique; Procedure: US-guided multi-injection technique

Study type: Interventional

Funder types: Other

Identifiers

NCT02429141

NAICE-001

Details and patient eligibility

About

In the transarterial technique for axillary brachial plexus block, the axillary artery is intentionally punctured to indicate placement of the needle within the neurovascular sheath; local anesthetic is then injected deep and superficial to the axillary artery.

Full description

To lessen the risk for hematoma and intravascular injection, several modifications, such as the multi-injection perineural technique, have become popular. These techniques require a high degree of technical skill and multiple needle passes, and also carry potential for injury. In this study, the investigators will compare an ultrasound-guided equivalent of the transarterial technique (periarterial injections) to a commonly used multi-injection perineural technique.

Enrollment: 50 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

1. Inclusion criteria:

   • Patients (ASA physical status I-III) scheduled to undergo hand or wrist surgery under axillary brachial plexus block

2. Exclusion criteria:

   • Patients with pre-existing neuropathy
   • Patients with allergy to local anesthetics
   • Patients with prior surgery in the ipsilateral axilla
   • Pregnant patients
   • Patients with difficulties in communication

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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50 participants in 2 patient groups

US-guided periarterial techique

Experimental group

Description:

Axillary brachial plexus block by an ultrasound-guided periarterial technique

Treatment:

Procedure: US-guided periarterial techique

US-guided multi-injection technique

Experimental group

Description:

Ultrasound-guided multi-injection perineural technique for axillary brachial plexus

Treatment:

Procedure: US-guided multi-injection technique