PECS II Versus ICBN Block Plus SCNB for AV Fistula Creation in CRF Patients

Postoperative Pain Clinical Trial

Official title:

Comparison Between Ultrasound-guided Pectoral Nerves Block Type II and Intercostobrachial Nerve Block as a Supplement to Supraclavicular Block for Anesthesia of Proximal Arteriovenous Access in End-stage Renal Disease Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04988776
• Other study ID #: PECS II versus ICBN block
• Status: Completed
• Phase: Phase 1/Phase 2
• Start date: February 1, 2020
• Est. completion date: February 28, 2021

Study information

• Verified date: September 2021
• Source: Menoufia University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Brachial plexus block (BPB) is often utilized for proximal arm arteriovenous access creation. However, the medial upper arm and axilla are often inadequately anesthetized, as the Intercostobrachial nerve (which provides sensory supply to the axilla, upper medial arm, and a small area at the upper lateral chest) is not a component of the brachial plexus. This requires repeated, an intraoperative local anesthetic (LA) supplementation up to conversion into GA. The intercostobrachial nerve (ICBN) is a purely sensory nerve that arises primarily from the second intercostal nerve (T2) with occasional contribution from T3. Therefore, It is not a component of the brachial plexus and is not anesthetized by brachial plexus blockade. The ICBN can be blocked together with other nerves, such as the pectoral, intercostal, and long thoracic nerves in a recently described technique named pectoral nerves block type II (PECS II ).In this thesis, investigators compared the use of the PECS II block and ICBN block as a supplement to supraclavicular brachial plexus block for providing complete anesthesia of the upper arm for fistula creation surgery.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: February 28, 2021
• Est. primary completion date: February 28, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

• ESRD patients.

• Proximal Arm Arteriovenous Access Surgery.

• Elective or emergency surgery

• American Society of Anesthesiology (ASA) physical status II to III.

Exclusion Criteria:

• Inability of the patient to provide informed consent, communicate or cooperate

• History of allergy to local anesthetics.

• Preexisting upper limb neurological disease at the side of the surgery.

• Patients on anticoagulant therapy or with history of coagulopathy.

• Previous surgery at or near the site of the study.

• The presence of skin infection at the puncture site.

Related Conditions & MeSH terms

• Intraoperative Analgesia
• Pain, Postoperative
• Postoperative Pain

Intervention

Other:
• ultrasUltrasound-guided Intercostobrachial nerve block supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 m
patients recieved ultrasound-guided Intercostobrachial nerve block with 10 ml 0.25% bupivacaine (5 ml 0.5% bupivacaine will be added to 5ml 0.9% normal saline ) supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 ml of 0.9 %Nacl ) .
• ultrasound-guided pectoral nerves block type II supplemental to supraclavicular block
Patients received ultrasound-guided pectoral nerves block type II with 10 ml 0.25% bupivacaine (5 ml 0.5% bupivacaine will be added to 5ml 0.9% normal saline ) supplemental to supraclavicular block with 30 ml 0.25% bupivacaine (15 ml 0.5% bupivacaine will be added to 15 ml of 0.9 %Nacl )

Locations

Country	Name	City	State
Egypt	Ashraf Magdy Eskandr	Shibin Al Kawm	Menoufia

Sponsors (4)

Lead Sponsor	Collaborator
Menoufia University	amany aly sultan, Mamdoh Elsayed Lotfy, reem gaber abdel-mageed

Country where clinical trial is conducted

Egypt, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	intraoperative local anesthetic requirement	volume of local anesthetic	1-2 hours after surgery start
Secondary	postoperative pain	Visual analogue score (0-10) where 0=no pain and 10=the worst pain	24 hours after end of surgery