Brachial Plexus Block Clinical Trial
Official title:
A Prospective, Randomized Comparison Between Lateral and Posterior Approach In Ultrasound-Guided Parasagittal In-Plane Infraclavicular Brachial Plexus Block
The lateral parasagittal in-plane is the current conventional approach in ultrasound-guided infraclavicular brachial plexus block. However this technique is less popular because brachial plexus at the infraclavicular level runs deeper compared to its course proximally, often give rise to impaired needle visualisation due to its steep angle of needle trajectory to the ultrasound beam. A new posterior parasagittal in-plane approach was introduced to improve needle visibility. This approach proved feasible from our case series hence the investigators would like to compare it with the conventional method in this study
This study compared the conventional lateral and posterior approach parasagittal in-plane
ultrasound guided infraclavicular brachial plexus block for upper limb surgery. A cadaveric
study was also performed to complement the findings.
After obtaining approval from the Medical Ethics Committee, University Malaya Medical Centre
(IRB reference no. 949.14 dated 17 October 2012), 46 patients undergoing upper limb surgery
were prospectively recruited and randomized. A cadaveric dissection was also performed.
DESIGN: Prospective randomized study
SETTING: Single centre, University of Malaya Medical Centre, Kuala Lumpur, Malaysia;
November 2012 to October 2013
INTERVENTION: Ultrasound guided, lateral or posterior parasagittal in-plane infraclavicular
brachial plexus blocks were performed on patients, depending on randomization. All blocks
were performed using 21G x 4 inch Stimuplex A (B Braun Medical) without nerve stimulation
plus SonoSite M-Turbo with HFL38x/ 13-6 MHz linear transducer probe. A 25-ml local
anaesthetic admixture [Lignocaine 2% (100mg) plus Ropivacaine 0.75% (150mg)] were injected
to all patients. A total volume of normal saline 0.9% 25ml mixed with methylene blue (0.2ml)
was used for cadaveric study.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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