Describe Novel Approach to Brachial Plexus Anesthesia Clinical Trial
Official title:
Ultrasound-Guided Brachial Plexus Regional Anesthesia by the Novel Retroclavicular Approach : A Feasibility Study
The goal of this study is to demonstrate that the novel retroclavicular approach is a safe, fast and effective technique for ultrasound-guided brachial plexus anesthesia.
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.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care