The Simultaneous Use of Supraclavicular and Distal Blocks

Ankara University

Status and phase: Completed; Phase 4

Conditions: Anaesthesia; Nerve Block; Orthopaedic Disorders

Treatments: Drug: Lidocaine; Drug: Levobupivacaine; Drug: Premedication midazolam; Procedure: Supraclavicular block and ultrasound-guided ulnar, median and radial nerve blocks.; Procedure: intravenous cannulation.; Drug: Epinephrine; Device: Routine ASA monitoring; Device: Intravenous cannulation.

Study type: Interventional

Funder types: Other

Identifiers

NCT01989312

03-99-12

Details and patient eligibility

About

The aim of this study is to compare the combined ultrasound-guided supraclavicular brachial plexus block and distal median, radial, and ulnar nerve blocks, with supraclavicular block alone.

Sixty two patients undergoing upper extremity surgery will be randomized to supraclavicular only (Group S, n=31) or supraclavicular + distal (Group SD, n=31) group. Patients in group S will receive 32 mL of lidocaine 1.5% + epinephrine 5µg/mL and in group SD receive 20 mL of lidocaine 1.5% + epinephrine 5µg/mL followed by a distal median, radial, and ulnar nerve blocks using 50:50 mixture of lidocaine 2% + levobupivacaine 0.5% (4 mL/nerve). Sensory and motor block of the ulnar, median, radial and musculocutaneous nerves will be assessed every 5 minutes starting at the 10th minutes. The imaging, needling and performance times will be recorded. Also the onset and anesthesia related times, need for analgesic and first analgesic time will be noted.

Enrollment: 75 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 and 80 years old patient
• American Society of Anesthesiologists (ASA) physical status I-III
• Scheduled for elective hand and forearm surgery

Exclusion criteria

• patient refusal
• preexisting neuropathy
• coagulopathy
• allergy to agents used
• pregnancy
• body mass index > 35 kg/m2
• chronic obstructive pulmonary disease
• infection or previous surgery in the supraclavicular area
• systemic infection

Trial design

75 participants in 2 patient groups

supraclavicular block

Active Comparator group

Description:

A supraclavicular block with 32 mL of lidocaine 1.5% + epinephrine 5µg/mL was performed for the anaesthetic management of the forearm and hand.

Treatment:

Drug: Lidocaine

Drug: Epinephrine

Procedure: intravenous cannulation.

Drug: Premedication midazolam

Device: Routine ASA monitoring

Device: Intravenous cannulation.

Supraclavicular and median, ulnar, radial blocks

Active Comparator group

Description:

Patients in this group received 20 mL of lidocaine 1.5% + epinephrine 5µg/mL for supraclavicular block and after the supraclavicular block they recieved a distal median, radial, and ulnar nerve blocks using 50:50 mixture of lidocaine 2% + levobupivacaine 0.5% (4 mL/nerve).

Treatment:

Drug: Lidocaine

Drug: Epinephrine

Drug: Levobupivacaine

Drug: Premedication midazolam

Procedure: Supraclavicular block and ultrasound-guided ulnar, median and radial nerve blocks.

Device: Routine ASA monitoring

Device: Intravenous cannulation.