Upper Extremity Clinical Trial
Official title:
Single Versus Multiple Injections for Axillary Plexus Block: a Randomized Controlled Trial
Patients will be randomized to one of two groups:
1. Multiple injection group: Axillary brachial plexus block with multiple injections, with
the arm abducted, performed with the aid of ultrasound;
2. Single injection group: Axillary brachial plexus block with a single injection, with the
arm placed behind the head and the elbow flexed, performed with the aid of ultrasound
The study will be proposed to all patients undergoing formarm or hand surgery under axillary
brachial plexus block. Patients will be randomized to one of two groups The first group -
multiple injection group - will receive an ultrasound-guided axillary brachial plexus block
with the traditional technique, i.e. multiple injections of local anesthetic in proximity to
the 4 nerfs that innervate the arm. The arm will be abducted during the block procedure.
The second group - single injection group - will receive an ultrasound-guided axillary
brachial plexus block with the arm placed behind the head and the elbow flexed. In this
position the different nerfs group around the axillary artery where they will be blocked with
a single injection of local anesthetic.
All patients will receive the same type and amount of local anesthetic: 30 ml of a mixture of
ropivacaine 0.5 % + mepivacaine 1 %.
The primary outcome measure is the time needed for the performance of the block. Secondary
outcomes are: success rate of the block at 30 minutes after the injection, needling time,
time to first analgesic request, postoperative opioid consumption, pain scores at 12 and 24
hours postoperatively, block-related complications, and patient satisfaction. These outcomes
are further defined in the section below.
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