General Anesthesia, Versus Axillary Block for Ambulatory Hand Surgery: Randomized Prospective Study

Study Overview
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Brief Summary
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This study aims to compare between general anesthesia and axillary nerve block for ambulatory hand surgery regarding postoperative sleep pattern and efficacy.

Official Title
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General Anesthesia, Versus Axillary Block for Ambulatory Hand Surgery: Randomized Prospective Study

Conditions
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Anesthesia, Local

Intervention / Treatment
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* Drug: fentanyl 2µg/kg intravenously and maintained with isoflurane
* Procedure: Axillary nerve Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Physical Status: ASA I and II Patients after taking written and informed consent Body mass index less than 30 Exclusion Criteria: Refusal of procedure or participation in the study by patients. Physical status: ASA III or above Subjects presenting with allergy to local anesthetics, alcohol or drug abuse. Inability to cooperate mentally retarded patients. Bleeding disorders. Patients with preoperative obstructive sleep apnea (OSA) or any sleep disturbance. Patients with body mass index more than 30. Polytrauma patients or emergency operation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: General anesthesia<br>Patients will receive general anesthesia | Drug: fentanyl 2µg/kg intravenously and maintained with isoflurane<br>* Anesthesia will be induced using titration of intravenous propofol till loss of verbal contact and fentanyl 2µg/kg intravenously and maintained with isoflurane (end tidal up to 1.5%), oxygen in air 50:50 via a laryngeal mask.<br>|
| Experimental: Axillary Block<br>Patients will receive axillary nerve block | Procedure: Axillary nerve Block<br>* Axillary block will be performed using ultrasound technique. Patients will receive an axillary block under ultrasound guidance using a linear 5-12 MHz probe.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of Postoperative nausea and vomiting | Incidence of postoperative nausea and vomiting requiring treatment | First 24 hours postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analogue scale [VAS] | Visual analogue scale [VAS] will be used to measure pain score at 30 min, 1, 2, 4, 6, 8, 10, 12 and 24 h after surgery. All the study patients will be instructed about the use of the VAS scale before induction of anesthesia (VAS score 0 cm = no pain, VAS score 10 cm = worst possible pain) | First 24 hours postoperatively | 
| Pittsburgh Sleep Quality Index | Pittsburgh Sleep Quality Index will be used to measure postoperative sleep disturbance. It is formed of 19 items that assess seven clinically derived domains of sleep difficulties (Sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction) over a Likert scale (0-3) | First 24 hours postoperatively |