Single Versus Multiple Injections for Axillary Plexus Block

Hôpital du Valais

Status and phase: Completed; Phase 4

Conditions: Upper Extremity

Treatments: Drug: Single injection local anesthetic; Drug: Multiple injection local anesthetic

Study type: Interventional

Funder types: Other

Identifiers

NCT03378323

BAX Unique

Details and patient eligibility

About

Patients will be randomized to one of two groups:

1. Multiple injection group: Axillary brachial plexus block with multiple injections, with the arm abducted, performed with the aid of ultrasound;
2. Single injection group: Axillary brachial plexus block with a single injection, with the arm placed behind the head and the elbow flexed, performed with the aid of ultrasound

Full description

The study will be proposed to all patients undergoing formarm or hand surgery under axillary brachial plexus block. Patients will be randomized to one of two groups The first group - multiple injection group - will receive an ultrasound-guided axillary brachial plexus block with the traditional technique, i.e. multiple injections of local anesthetic in proximity to the 4 nerfs that innervate the arm. The arm will be abducted during the block procedure.

The second group - single injection group - will receive an ultrasound-guided axillary brachial plexus block with the arm placed behind the head and the elbow flexed. In this position the different nerfs group around the axillary artery where they will be blocked with a single injection of local anesthetic.

All patients will receive the same type and amount of local anesthetic: 30 ml of a mixture of ropivacaine 0.5 % + mepivacaine 1 %.

The primary outcome measure is the time needed for the performance of the block. Secondary outcomes are: success rate of the block at 30 minutes after the injection, needling time, time to first analgesic request, postoperative opioid consumption, pain scores at 12 and 24 hours postoperatively, block-related complications, and patient satisfaction. These outcomes are further defined in the section below.

Enrollment: 50 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients who undergo forearm or hand surgery under axillary brachial plexus block

Exclusion criteria

• History of allergic reaction to local anaesthetics
• Peripheral neuropathy
• Renal or hepatic insufficiency
• Coagulation disorders

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

Multiple injection local anesthetic

Active Comparator group

Description:

Ultrasound guided axillary plexus block with multiple injections of local anesthetic

Treatment:

Drug: Multiple injection local anesthetic

Single injection local anesthetic

Experimental group

Description:

Ultrasound guided axillary plexus block with a single injection of local anesthetic

Treatment:

Drug: Single injection local anesthetic