Continuous Infraclavicular Blocks: Neurostimulation Versus Ultrasound

Study Overview
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Brief Summary
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The purpose of this study is to determine whether ultrasound guidance or nerve stimulation is the best option for placing continuous peripheral nerve block catheters for upper limb surgery.

Detailed Description
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In a multidisciplinary, observer blinded, prospective, single center, randomized study, success rate of US guided versus neurostimulation guided catheter placement for continuous infraclavicular block in patients scheduled for upper limb surgery will be studied. Block effectiveness, time taken, discharge from recovery, postoperative pain and disability and patient acceptance will be studied in 210 patients.

Official Title
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Success Rate of Infra-clavicular Blocks: Comparison of Ultrasound Versus Neurostimulation Guided Catheter Placement

Conditions
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Disorder of Upper Extremity

Intervention / Treatment
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* Procedure: Ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-80 yrs Weight 40-100 kg Either sex Height >150 cm American Society of Anesthesiologists physical status 1-3 Scheduled for hand or elbow surgery under regional anesthesia Exclusion Criteria: Inability to give informed consent Refusal of treatment randomization Language barrier Allergy to any medications being used in the study protocol Ongoing major medical or psychiatric problems Chronic pain or narcotic use/abuse Peripheral neuropathy or major neurological problems Scarring in area of blockade Inability to co-operate with post-operative evaluation Major coagulopathy Pregnancy and breast feeding Patients requiring anesthesia of other surgical sites Obese patients (i.e. BMI >40) Postoperatively, patients will be excluded if they have had additional operative procedures requiring a change in the usual protocol of care

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Neurostimulation<br>Block catheter will be introduced using neurostimulation | Procedure: Ultrasound<br>* Block catheter will be introduced using ultraosound<br>|
| Active Comparator: Ultrasound<br>Block catheter will be introduced using ultrasound | Procedure: Ultrasound<br>* Block catheter will be introduced using ultraosound<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurostimulation versus ultrasound guided infraclavicular catheter placement | Comparision of block success with neurostimulation and ultrasound guided placed infraclavicular catheters | 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time taken for complete nerve block | Procedure time for both techniques | 14 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Brachial plexus, Ultrasound