An interventional study of NS-guided infraclavicular block and US-guided infraclavicular block in Pain, sponsored by Cheju Halla General Hospital. Completed at 1 site in South Korea. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2016-01-28.
Sponsored by Cheju Halla General Hospital · Not applicable, Interventional, and Treatment
The investigators compared the postoperative analgesia of nerve stimulator-guided and ultrasound-guided infraclavicular block for upper extremity surgery.
Ultrasound (US)-guided peripheral nerve block has increased in popularity. It has many advantages such as improved success rate, faster onset time, fewer needle passes, shorter performance time, and reduced procedural pain and vascular puncture. However, there is no information about postoperative analgesia.
Therefore, the investigators tested whether ultrasound-guided peripheral nerve block enhanced the postoperative analgesia for upper extremity surgery compared with nerve stimulator (NS) guidance.
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NS-guided infraclavicular block is performed using 35 ml of 0.5% ropivacaine.
Procedure: NS-guided infraclavicular block
US-guided infraclavicular block is performed using 35 ml of 0.5% ropivacaine.
Procedure: US-guided infraclavicular block
Patients received a standard single injection infraclavicular block using the lateral sagittal approach of Klaastad. The infraclavicular brachial plexus is identified using an insulated needle connected to a nerve stimulator. Placement of the needle is considered adequate if motor response of radial nerve in the hand or wrist is still present at 0.2 - 0.5mA. Ropivacaine 0.5% 35ml is used.
Infraclavicular block is performed under ultrasound guidance. Linear probe is placed in a parasagittal positon below the clavicle medial to the coracoid process and adjusted to achieve a cross-sectional image of the axillary artery. Using in-plane technique, an 22-gauge insulated needle is advanced caudally and posteriorly to the axillary artery. Subsequently, 35 ml of 0.5% ropivacaine is incrementally injected.
Duration of postoperative analgesia
time from completion of local anesthetic injection until the first request for an analgesic
Time frame: at 24h after surgery
block performance time
the time between the block needle insertion and needle withdrawal
Time frame: at 30 min after block placement
number of needle redirections
either forward or backward movement of needle at least 1 cm or more
Time frame: at 30 min after block placement
patient discomfort
pain score (0-10) during the procedure
Time frame: at 30 min after block placement
paresthesia
presence of paresthesia during the procedure
Time frame: at 30 min after block placement
onset time
complete block of sensory nerve (radial, ulnar, median, musculocutaneous, and medial antebrachial cutaneous nerve)
Time frame: until 30min after completion of local anesthetic
motor block of hand
presence of motor block in the operated hand
Time frame: at 24h after surgery
postoperative dysesthesia
presence of any paresthesia in the operated extremity
Time frame: at 24h after surgery
supplemental analgesia
Rescue analgesia with 75 mg of IM diclofenac was available on demand.
Time frame: at 24h after surgery
Pain score
Time frame: at 24h after surgery
Patient satisfaction
The acceptance of the anesthetic technique was evaluated using a two-point score: 1, satisfactory (if necessary, I would have the same anesthetic technique); and 2, unsatisfactory (different anesthetic technique).
Time frame: at 24h after surgery
This study is completed, as verified in Jan 2016. You cannot join it, but the record below documents what was studied.
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Cheju Halla General Hospital