Tissue Perfusion for Different Approaches of Brachial Plexus Block

Study Overview
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Brief Summary
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To compare the two different approaches of infraclavicular brachial plexus block in forearm, wrist and hand surgery in terms of perfusion index, tissue oxygenation, sensory and motor block onset time and total effect time, first analgesic time, side effects and complications, and duration of block application.

Official Title
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Effect of Different Approaches of Infraclavicular Brachial Plexus Block on Tissue Perfusion: A Randomized Trial

Conditions
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Upper Extremity Fracture, Regional Anesthesia, Brachial Plexus Blocks, Perfusion Index, Tissue Perfusion

Intervention / Treatment
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* Other: Lateral sagittal approach
* Other: Costoclavicular approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients who undergo elective forearm or hand surgery under infraclavicular brachial plexus block American Society of Anesthesiologists class 1 to 3 Ability to consent Exclusion Criteria: History of allergic reaction to local anaesthetics Peripheral neuropathy Renal or hepatic insufficiency Coagulation disorders

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Lateral sagittal approach<br>Patients in this group will be randomized to receive a lateral sagittal approach for Ultrasound Guided Infraclavicular Brachial Plexus Nerve Block . | Other: Lateral sagittal approach<br>* Lateral sagittal approach for ultrasound guided infraclavicular brachial plexus block<br>|
| Active Comparator: Costoclavicular approach<br>Patients in this group will be randomized to receive a costoclavicular approach to Ultrasound Guided Infraclavicular Brachial Plexus Nerve Block . | Other: Costoclavicular approach<br>* Costoclavicular approach for ultrasound guided infraclavicular brachial plexus block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| perfusion index | the effect of the block on the perfusion index | up to motor block scale ≥3 | 
| tissue oxygenation | the effect of the block on the tissue oxygenation | up to motor block scale ≥3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| motor block onset time | quality of motor block scale ≥2 | Assessed 40 minutes after block completion | 
| sensorial block onset time | quality of sensorial block scale ≥2 | up to 24 hours | 
| complications | block related complications such as pneumothorax, vascular injury, local anesthetic systemic toxicity | up to 24 hours | 
| duration of block application | from the needle puncture to the end of the local anesthetic injection | during the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lateral sagittal approach, costoclavicular approach, block success, perfusion index, brachial plexus