Ultrasound-Guided Axillary or Infraclavicular Nerve Block for Upper Limb Surgery

University of Parma

Status and phase: Completed; Phase 4

Conditions: Forearm Injuries; Orthopedic Surgery; Nerve Block; Trauma; Upper Extremity

Treatments: Drug: Midazolam; Procedure: Axillary brachial plexus nerve block; Drug: Fentanyl; Procedure: Infraclavicular brachial plexus block; Procedure: General anesthesia; Drug: Ropivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT00724035

ANEST-ORT-02

Details and patient eligibility

About

This study aims to detect differences in onset time of brachial plexus (i.e., arm) anesthesia using two different nerve block techniques.

Using ultrasound guidance, axillary (i.e., at the armpit) and infraclavicular (i.e., below the collarbone) blocks will be performed to patients undergoing upper limb surgery.

The investigators will analyze how long it takes for anesthesia to be adequate for pain-free surgery, thus determine the optimal technique for this kind of surgery.

Full description

Real-time ultrasound guidance has substantially reduced the risk of pneumothorax and/or vascular puncture during infraclavicular brachial plexus blocks. The role of this technique has thus been expanded to overlap those procedures for which an axillary nerve block would be commonly considered as first choice.

A reference block for upper limb surgery thanks to its safety profile and clinical efficacy, the axillary approach may be more painful or unpleasant for some patients.

The investigators aim to determine possible differences in onset time and patient acceptance between the two techniques.

Enrollment: 52 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ASA Physical Status Class <4
• Scheduled upper extremity orthopedic surgery

Exclusion criteria

• Psychiatric or cognitive disorder
• Allergy to study drugs
• Contraindication to nerve block at the assigned site

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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52 participants in 2 patient groups

Infraclavicular

Experimental group

Description:

This group will receive an ultrasound-guided infraclavicular brachial plexus block.

Treatment:

Drug: Ropivacaine

Drug: Midazolam

Procedure: General anesthesia

Procedure: Infraclavicular brachial plexus block

Drug: Fentanyl

Axillary

Active Comparator group

Description:

This group will receive an ultrasound-guided axillary brachial plexus block.

Treatment:

Drug: Ropivacaine

Drug: Midazolam

Procedure: General anesthesia

Drug: Fentanyl

Procedure: Axillary brachial plexus nerve block