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CompletedNCT03378323Updated Apr 11, 2019

Single Versus Multiple Injections for Axillary Plexus Block

A Phase 4 interventional study of Multiple injection local anesthetic and Single injection local anesthetic in Upper Extremity, sponsored by Hôpital du Valais. Completed at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-04-11.

Sponsored by Hôpital du Valais · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

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
Read the detailed description

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.

02

Conditions studied

  • Upper Extremity

Keywords

  • upper extremity surgery
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult patients who undergo forearm or hand surgery under axillary brachial plexus block

Exclusion criteria

Exclusion Criteria:

  • History of allergic reaction to local anaesthetics
  • Peripheral neuropathy
  • Renal or hepatic insufficiency
  • Coagulation disorders
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
50 participants (actual)

Study arms

  • Active comparator
    Multiple injection local anesthetic

    Ultrasound guided axillary plexus block with multiple injections of local anesthetic

    Drug: Multiple injection local anesthetic

  • Experimental
    Single injection local anesthetic

    Ultrasound guided axillary plexus block with a single injection of local anesthetic

    Drug: Single injection local anesthetic

Interventions

  • DrugMultiple injection local anesthetic

    Multiple injection local anesthetic

  • DrugSingle injection local anesthetic

    Single injection local anesthetic

05

What researchers measure

Primary outcomes

  1. Performance time

    Time in minutes from ultrasound probe placement to end of local anesthetic injection

    Time frame: 10 minutes

Secondary outcomes

  1. Needling time

    Time in seconds to complete the block

    Time frame: 15 minutes

  2. Time to first analgesic request

    Time in minutes to first analgesic request postoperatively

    Time frame: 24 hours

  3. Block-related complications

    Infection, bleeding, neurological problems, pain during the 24 postoperative hours

    Time frame: 24 hours

  4. Postoperative opioid consumption on postoperative day 1

    intravenous morphine equivalent consumption during the 24 postoperative hours

    Time frame: 24 hours

  5. Pain scores at 12 hours postoperatively

    Measured on a visual analogue scale between 0 and 10 (0 = no pain, 10 = worst pain imaginable)

    Time frame: 12 hours

  6. Pain scores on postoperative day 1

    Measured on a visual analogue scale between 0 and 10 (0 = no pain, 10 = worst pain imaginable)

    Time frame: 24 hours

  7. Patient satisfaction

    Assessed by numerical rating scale on a scale between 0 (= completely dissatisfied) and 10 (= completely satisfied)

    Time frame: 24 hours

06

Study locations

1 site
  • Hopital du Valais
    Sion, 1950, Switzerland
07

Registry details

Key details

Study ID
NCT03378323
Lead sponsor
Hôpital du Valais
Collaborators
University of Lausanne Hospitals
Responsible party
Sina Grape (Dr, Hôpital du Valais) — Principal investigator
First posted
Dec 19, 2017
Start date
Jul 1, 2018
Primary completion
Apr 9, 2019
Completion
Apr 10, 2019
Last update
Apr 11, 2019

Study contacts

Sina Grape, MD
principal investigator · Hôpital du Valais
Eric Albrecht, MD
study director · University of Lausanne Hospitals

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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