Anesthesia, Local Clinical Trial
Official title:
Ultrasound-guided Selective Supraclavicular Nerve Block With Either Superior Trunk or Clavipectoral Fascial Plane Block for Clavicular Surgery
Surgical fixation for acute clavicular fractures is increasingly preferred among orthopedic surgeons to improve healing and decrease the risk of malunion. Regional anesthesia for clavicular fractures allows rapid recovery, prolonged postoperative analgesia, and less opioid consumption, and so decreases the hospital stay. There is no consensus regarding the best regional anesthetic technique for surgical fixation for acute clavicular fractures. Selective supraclavicular nerve block combined with either superior trunk or clavipectoral fascial plane block is a promising regional anesthetic technique for midshaft clavicular surgeries.
Status | Recruiting |
Enrollment | 54 |
Est. completion date | August 2024 |
Est. primary completion date | June 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 45 Years |
Eligibility | Inclusion Criteria: - Age: 18-45 years old. - Sex: both sexes. - The American Society of Anesthesiologists (ASA) Physical status: ASA I & II. - Body mass index (BMI): 18.5 - 24.9 kg/m2. - Type of operations: surgical repair of the midshaft clavicular injuries. Exclusion Criteria: - Patient refusal. - Known hypersensitivity to lidocaine or bupivacaine. - Patients with respiratory insufficiency. - Coagulation disorders or taking drugs affect surgical hemostasis. - Patients with pre-existing neurological deficits - Uncooperative patient or with altered mental status. |
Country | Name | City | State |
---|---|---|---|
Egypt | Zagazig university hospital | Zagazig | Al-Sharkia |
Lead Sponsor | Collaborator |
---|---|
Zagazig University |
Egypt,
Banerjee S, Acharya R, Sriramka B. Ultrasound-Guided Inter-scalene Brachial Plexus Block with Superficial Cervical Plexus Block Compared with General Anesthesia in Patients Undergoing Clavicular Surgery: A Comparative Analysis. Anesth Essays Res. 2019 Jan-Mar;13(1):149-154. doi: 10.4103/aer.AER_185_18. — View Citation
Goncalves D, Sousa CP, Graca R, Miguelez MP, Sampaio C. Clavipectoral Fascia Plane Block Combined With Superficial Cervical Plexus Block for the Removal of Osteosynthesis Material From Clavicle Fracture. Cureus. 2023 Aug 8;15(8):e43146. doi: 10.7759/cureus.43146. eCollection 2023 Aug. — View Citation
Kang R, Jeong JS, Chin KJ, Yoo JC, Lee JH, Choi SJ, Gwak MS, Hahm TS, Ko JS. Superior Trunk Block Provides Noninferior Analgesia Compared with Interscalene Brachial Plexus Block in Arthroscopic Shoulder Surgery. Anesthesiology. 2019 Dec;131(6):1316-1326. doi: 10.1097/ALN.0000000000002919. — View Citation
Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):452-6. doi: 10.1067/mse.2002.126613. — View Citation
Valdes-Vilches LF, Sanchez-del Aguila MJ. Anesthesia for clavicular fracture: selective supraclavicular nerve block is the key. Reg Anesth Pain Med. 2014 May-Jun;39(3):258-9. doi: 10.1097/AAP.0000000000000057. No abstract available. — View Citation
Virtanen KJ, Malmivaara AO, Remes VM, Paavola MP. Operative and nonoperative treatment of clavicle fractures in adults. Acta Orthop. 2012 Feb;83(1):65-73. doi: 10.3109/17453674.2011.652884. Epub 2012 Jan 17. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Time of the first rescue analgesic request by the patient postoperative. | The patient will be asked to quantify postoperative pain using the visual analogue pain score as the following 0: no pain, and 10: maximum imaginable pain. Nalbuphine 4 mg will be administered intravenous as rescue analgesia if the visual analogue pain score =4. The time of the first rescue analgesic request will be recorded. | 24 hours | |
Secondary | Onset of sensory block. | From the end of block procedure to the of loss of pin prick sensation will be tested over the affected clavicle. | 20 minutes | |
Secondary | Ipsilateral diaphragmatic excursion affection. | Ipsilateral diaphragmatic excursion will be assessed by M-mode ultrasound. | 1 hour | |
Secondary | The Numerical Pain Rating Scale in the first 24 hours | On a scale of 0-10, the patient will be asked to quantify postoperative pain as the following 0: no pain, and 10: maximum imaginable pain. | 24 hours. | |
Secondary | The total opioid consumption in the first 24 hours | The total dose of intravenous nalbuphine in the first 24 hours postoperatively | 24 hours. | |
Secondary | Patient and surgeon satisfaction. | Patient and surgeon satisfaction will be assessed using 7- point Likert-like verbal rating scale. | 24 hours | |
Secondary | Any reported complications. | The possible side effects will be followed in the first 24 hours postoperative. | 24 hours. |
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