Parasagittal Vs Cornerpocket Approaches

Supraclavicular Brachial Plexus Block Clinical Trial

Official title:

Parasagittal Vs Cornerpocket Approaches for Ultrasound Guided Supraclavicular Brachial Plexus Block A Comparative Study

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06352333
• Other study ID #: Parasagittal Vs Cornerpocket
• Status: Not yet recruiting
• Phase: N/A
• Start date: April 2, 2024
• Est. completion date: January 1, 2025

Study information

• Verified date: April 2024
• Source: Sohag University
• Contact: Nada t Ahmed, resident
• Phone: 01069459544
• Email: nada_abdelrohman[@]yahoo.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Brachial plexus blocks are widely used to provide anesthesia for upper limb surgery. Although many different approaches to the brachial plexus block have been described, there is widespread acceptance that injecting at the supraclavicular level is the most reliable method in terms of spread of local anesthetic agent. Each approach of ultrasound guided supraclavicular brachial plexus block (US -SCBPB ) has a different success rate and complications. . A supraclavicular block can provide effective surgical anesthesia of the forearm and hand. The most commonly performed US- SCBPB is the corner pocket approach which was described by Chan et al with probe resting posterior to the clavicle, with postero latero-anteromedial orientation provides a very stable location, but has the disadvantage of "looking" across the first rib, with the apex of the lung visualized close to thePlexus . A new Parasagittal approach for brachial plexus block at the supraclavicular level was studied by Adrian Searle where the arc of the first rib was used to provide a deep limit to needle transit in order to minimize the risk of pneumothorax ;the aim of our study is to further evaluate the parasagittal approach for brachial plexus block and compare it with the popular corner pocket approach

Description:

After approval of research ethics committee of Sohag University hospital, a written consent will be taken from all participants to use their data for research and educational purposes The study will be carried on 80 participants who undergo elective upper limb surgery for a comparative study. In this study the investigators will use A 22 G Spinal needle , a high frequency linear probe of US and 2 % lidocaine and 0.5% bupivacaine as local anathetics ,Every participant will be informed about advantages and disadvantages of the research and has the right to withdraw at any stage without negative impact on medical service production. For both types of block: Wide bored cannula is inserted,Monitoring is applied (pulse,Ecg,Bp) Oxygen mask 5 liters , Participants were positioned supine with the head turned to the non-operative Side ( contralateral side), and a pillow under the head and shoulder with the ipsilateral arm placed adducted by the patient side. After that we sterilize the skin and apply a local anesthetic (2-3 ml of2% lidocaine). The total volume of the local anesthetic mixture was 30 ml (10 ml of 2% lidocaine mixed with 20 ml of 0.5% bupivacine ) Then participants will be divided randomly into 2 groups ,each group 40 participants.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 80
• Est. completion date: January 1, 2025
• Est. primary completion date: November 1, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• 18 to 60 years old
• ASA grade I to II
• Elective upper limb surgery

Exclusion Criteria:

• Patient refusal.
• Patient with neurological deficit in the limb of surgery
• Patients with psychiatric disease.
• Coagulopathy.
• Morbid obesity.
• Known allergy to used local anathetics
• Local infection at the block site.

Related Conditions & MeSH terms

• Supraclavicular Brachial Plexus Block

Intervention

Procedure:
• supraclavicular ultrasound guided brachial plexus block
two approaches of ultrasound guided supraclavicular brachial plexus block in upper limb surgery : the cornerpocket supraclavicular brachial plexus block and parasagittal supraclavicular brachial plexus block

Locations

Country	Name	City	State
Egypt	Sohag university Hospital	Sohag

Sponsors (1)

Lead Sponsor	Collaborator
Sohag University

Country where clinical trial is conducted

Egypt, 

References & Publications (4)

Chan VWS, Perlas A, Rawson R, Odukoya O. Ultrasound-guided supraclavicular brachial plexus block. Anesth Analg. 2003 Nov;97(5):1514-1517. doi: 10.1213/01.ANE.0000062519.61520.14. — View Citation

Choi S, McCartney CJ. Evidence Base for the Use of Ultrasound for Upper Extremity Blocks: 2014 Update. Reg Anesth Pain Med. 2016 Mar-Apr;41(2):242-50. doi: 10.1097/AAP.0000000000000155. — View Citation

Duggan E, El Beheiry H, Perlas A, Lupu M, Nuica A, Chan VW, Brull R. Minimum effective volume of local anesthetic for ultrasound-guided supraclavicular brachial plexus block. Reg Anesth Pain Med. 2009 May-Jun;34(3):215-8. doi: 10.1097/AAP.0b013e31819a9542. — View Citation

Soares LG, Brull R, Lai J, Chan VW. Eight ball, corner pocket: the optimal needle position for ultrasound-guided supraclavicular block. Reg Anesth Pain Med. 2007 Jan-Feb;32(1):94-5. doi: 10.1016/j.rapm.2006.10.007. No abstract available. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Success rate	Measrue number of failed and successful nerve blocks	1 year
Other	Complications	Measure complications of the block	1 year
Primary	Needle visibility in both approaches	Measure the visibility of the needles in the ultrasound	1 year
Secondary	Duration of sensory and motor block	Measure the time of sensory and motor block start to happen after injecting local anathetics	1 year