Hand Injuries Clinical Trial
Official title:
Retroclavicular Approach vs Infraclavicular Approach for Brachial Plexus Block in Obese
The retroclavicular approach for brachial plexus anesthesia requires an optimal angle between the needle and the ultrasound beam. Retroclavicular approach has already been proven effective and safe in the past. The general objective is to provide a formal comparison between the retroclavicular approach and coracoid infraclavicular approach for brachial plexus anaesthesia. This study should represent the differences between the two techniques.
Classic infraclavicular approach of the brachial plexus involves a needle puncture below the
clavicle and advancing the needle with a 45-60 degree angle from cephalad to caudad. The aim
is to advanced the block needle posterior to the axillary artery and to deposit the local
anesthetic at that point, near the posterior cord. A "U" shaped spread around the artery
should ensure distribution around all three cords. Ultrasound guidance is highly recommended
and neurostimulation is optional.
The retroclavicular approach is a variant to this classical technique. Ultrasound probe is
positioned initially below the clavicle in a manner similar to the classic approach but is
then rotated in a clockwise fashion (right arm) or counter-clockwise fashion (left arm) for
about 25-35 degrees. The puncture site is just behind the clavicle at the most lateral point
available. If initial entry point is optimal, needle direction is then parallel to
ultrasound probe. The final aim and position of block needle is identical to classical
approach. Entry point ensures a parallel alignment of the needle and the ultrasound beam,
thus enabling almost perfect visualization of both artery, cords and block needle. This is
turn optimizes safety, rapidity of technique, efficiency and efficacy.
It is recognized that regional anesthesia is more difficult to perform in obese patients.
Anatomic landmarks are harder to localize in this population and ultrasound guidance is more
difficult because of the attenuation of the ultrasound beam by adipose tissue. The
complication rate of regional techniques is also reported to be higher in the obese patient
population.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor)
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05846399 -
CAT BITE Antibiotic Prophylaxis for the Hand/Forearm (CATBITE)
|
Phase 4 | |
Withdrawn |
NCT04291170 -
Comparison of Upper Extremity and Lower Extremity Function and Quick DASH
|
N/A | |
Not yet recruiting |
NCT05060900 -
Hand Ligament Reconstructions With Knee Collateral Ligament Allografts
|
N/A | |
Active, not recruiting |
NCT05280704 -
Traditional Dorsal Digital Block vs Volar Subcutaneous Digital Block
|
N/A | |
Not yet recruiting |
NCT05003596 -
Efficacy of Steroids on Functional Outcomes After Musculoskeletal Injuries of the Hand
|
Phase 2/Phase 3 | |
Completed |
NCT04068506 -
Analgesic Effects of Gabapentin and Paracetamol
|
Phase 4 | |
Not yet recruiting |
NCT03937232 -
Mirrored Movement Compared to Cross-education
|
N/A | |
Completed |
NCT04328623 -
Interest of Hypnosis on Pain Management During a Guided Echo Infiltration of the Hand
|
N/A | |
Recruiting |
NCT04895891 -
3D Personalized Modelization of the Hand Using EOS Imaging System
|
N/A | |
Completed |
NCT01210833 -
Using HandTutor With Traumatic Hand Injuries: Characterizing the System
|
N/A | |
Recruiting |
NCT06086392 -
Perineural Dexamethasone in Supraclavicular Brachial Plexus Block for Anesthesia After Pediatric Hand/Wrist Surgery
|
Phase 4 | |
Completed |
NCT05878509 -
Reliability and Validity of the Tampa Scale for Kinesiophobia
|
||
Withdrawn |
NCT04027569 -
PROMs To Improve Care- Standardized vs Patient Specific
|
N/A | |
Completed |
NCT03345693 -
Use of MoTrack Therapy in At-Home Hand Rehabilitation
|
N/A | |
Completed |
NCT06112145 -
Are Rehabilitation Results in Flexor Tendon Zone II Injuries as Bad as Feared?
|
N/A | |
Completed |
NCT03496337 -
Is AMPS a Responsive Tool for Assessing Change in ADL-abilities After Finger or Hand Surgery
|
||
Completed |
NCT02789852 -
Evaluation of the Effectiveness of Night Orthosis in Treating Women With Symptomatic Osteoarthritis in the Interphalangeal Joint of the Dominant Hand
|
N/A | |
Completed |
NCT02331004 -
Effectiveness of an Intervention Program for Fine Motor Skills
|
N/A | |
Completed |
NCT04486053 -
Long-term Results of Pediatric Flexor Tendon Injuries
|
||
Completed |
NCT03458013 -
Psychosocial Outcomes in Hand Therapy
|
N/A |