Anesthesia Clinical Trial
Official title:
Diaphragmatic Dysfunction After Ultrasound-guided Supraclavicular Brachial Plexus Block With the Double Injection Technique
The investigators plan to determine the onset time and incidence of hemidiaphragmatic paresis
(HDP) with a double injection supraclavicular nerve block in patients presenting for upper
extremity surgery below the elbow.
The hypothesis is HDP following supraclavicular brachial plexus block occurs with-in 15
minutes of block performance and is not associated with subjective dyspnea.
This study will be an observational trial to assess the onset time and incidence of
hemidiaphragmatic paresis in patients who undergo the double injection ultrasound-guided
supraclavicular block. Diaphragmatic dysfunction will be determined by intercostal diaphragm
thickening measured using ultrasound. The available image will be saved.
Patients having below the elbow surgery will be be approached by someone from the research
team for consent and possible inclusion in the study. This will be done in the anesthesia
preoperative assessment clinic, or in the pre-op area on the day of surgery (if a patient was
not seen in clinic).
A baseline ultrasonographic diaphragmatic assessment will be completed. Study participants
will then receive supraclavicular brachial plexus block as per standard of care.
Ultrasonographic diaphragmatic assessment and dyspnea score (using modified Borg dyspnea
scale) will be performed every 5 minutes for 30 minutes, or until the patient is transferred
to the operating room, whatever comes first. Patients will also undergo an ultrasonographic
diaphragmatic assessment and dyspnea score in the recovery room after their surgery.
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