Injection Optimization of Infraclavicular and Axillary Brachial Plexus Block
Condition: Brachial Plexus Block
Study type: Interventional

Summary: 
      In upper extremity surgery, brachial plexus block (BPB) is routinely applied successfully as
      general anesthesia (GA). However, BPB is less invasive technique than GA. Peripheral nerve
      blocks have some potential benefits, such as lower risk of nausea and vomiting, early
      ambulation, early discharge, and better control of postoperative pain. The BPB is applied to
      various areas such as axillary, supraclavicular, infraclavicular and interscalene areas under
      the guidance of ultrasound and nerve stimulator. Among these methods, BPB administration
      success rates are around 95-100%. The other condition is anesthetic time which is important
      for the turnover of operating room. Anesthetic time is the sum of the performance time and
      onset time. In addition performance time and number of needle attempts also associated with
      patient satisfaction. The primary aim of this study is to determine the number of attempts
      and the performance time with the onset time and anesthetic time. If the procedure is simple,
      the performance time may be shorter. Therefore, the investigators aim that comparison of two
      different procedures which are single injection infraclavicular brachial plexus block and
      multiple injection axillary brachial plexus block by ultrasound guidance. In addition, the
      investigators will examine the duration of anesthesia and surgery, the duration of sensory
      and motor block endings, patient comfort and pain scales in the postoperative period.
    

Detailed description: 
      60 participants who underwent forearm or hand surgery with the axillary or infraclavicular
      brachial plexus block method and who have an American Society of Anesthesiologists physical
      status classification (ASA) score of I-II-III between the ages of 18-75 will be followed up.
      Number of needle attempts, block performance time, sensorial and motor block onset time,
      total anesthetic time, surgical duration, duration of sensory block formation, and duration
      of motor block formation will be evaluated with the information obtained from participants
      with axillary block or infraclavicular block. After surgery, participants satisfaction,
      visual analogue scales (VAS), sensory block ending times, motor block ending times and first
      analgesic requirement time will be assessed at postoperative 2. -8. -12. -24. hours by
      physical examination and questions. As a result of these evaluations, both groups will be
      compared statistically. (After the patients are informed in detail, the volunteer certificate
      will be obtained from the patients who agree to participate in the study.)
    

Intervention name(s): Infraclavicular brachial plexus block; axillary brachial plexus block
Intervention type(s): Other; Other
Intervention description(s): Infraclavicular block will be performed with ultrasound guidance and peripheric nerve stimulator. Local anesthetic will be administered after aspiration, via peripheric nerve needle according to mentioned technique ( https://www.nysora.com/); Axillary nerve block will be performed with ultrasound guidance and peripheric nerve stimulator. Local anesthetic will be administered after aspiration via peripheric nerve needle according to mentioned technique ( https://www.nysora.com/)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: infraclavicular block; axillary block