Jedi Grip Versus Double Operator Technique For Ultrasound Guided Infraclavicular Block

Study Overview
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Brief Summary
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The investigators aimed to compare the block characteristics of the single operator jedi grip technique and the conventional double operator technique.

Detailed Description
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Patients undergoing hand, wrist, elbow and forearm surgery randomly assigned two groups (Group I: Jedi grip and Group II: Conventional double operator technique). By a blind observer, the block characteristics were evaluated and recorded .

Official Title
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A Prospective, Randomized, Observer-Blinded Comparison Between Single And Double Operator In Ultrasound Guided Infraclavicular Block: Jedi Grip Versus Conventional Double Operator Technique

Conditions
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Ultrasound, Nerve Block

Intervention / Treatment
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* Procedure: USG guided infraclavicular block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: undergoing elective hand, wrist and forearm surgery Exclusion Criteria: hepatic or renal failure serious cardiac or pulmoner disease local or systemic infection sepsis coagulation disorder neurological, muscular or psychiatric disease body mass index (BMI) below 18.5 or above 35 drug and substance abuse pregnancy refusal of regional anesthesia history of allergy to local anesthetics mental-motor retardation (inability to consent or assess the visual analog scale(VAS) pain score) preoperative long-term NSAIDs or opioid use.

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: single-center, prospective, randomized into two goups: Jedi grip versus conventional double operator technique
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group I<br>USG guided infraclavicular block with single operator jedi grip technique | Procedure: USG guided infraclavicular block<br>* USG guided infraclavicular block was applied to patients either by conventional two-person technique or by one person Jedi technique according to the allocated group. On Group I single operator controlled the probe with one hand while controlling the needle and the syringe on the other hand with the Jedi technique. The needle was held between the index finger and the middle phalanx of the middle finger, and the syringe was held with fingers 4 and 5, with the plunger part to the thumb in the palm. On Group II, operator used the probe and needle with different hands while an assistant controlling the syringe to aspirate or inject local anesthetic.<br>|
| Active Comparator: Group 2<br>USG guided infraclavicular block with conventional double operator technique | Procedure: USG guided infraclavicular block<br>* USG guided infraclavicular block was applied to patients either by conventional two-person technique or by one person Jedi technique according to the allocated group. On Group I single operator controlled the probe with one hand while controlling the needle and the syringe on the other hand with the Jedi technique. The needle was held between the index finger and the middle phalanx of the middle finger, and the syringe was held with fingers 4 and 5, with the plunger part to the thumb in the palm. On Group II, operator used the probe and needle with different hands while an assistant controlling the syringe to aspirate or inject local anesthetic.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| block performance time | teh sum of imaging and needling time | during block application | 
| block success | incidence of ( %) surgery with successful anesthesia | during surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensory block onset time | Sensory blockage was evaluated and graded; from lateral to the forearm, the volar face of the thumb, volar face of the 5th finger and lateral side of the hand back; for musculocutaneous, median, ulnar and radial nerves, respectively. Graduation was according to a previously validated 3-point scale using a cold test: 0 = no block, 1 = analgesia (patient can feel touch, not cold), and 2 = anesthesia (patient cannot feel touch) | before surgery | 
| motor block onset time | blockage was evaluated and graded; with elbow flexion, thumb abduction, thumb opposition, thumb adduction for musculocutaneous, radial, median, ulnar nerves respectively. Motor blockage graduation was also according to a (validated) 3-point scale: 0 = no block, 1 = paresis and 2 = paralysis. | before surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Jedi Grip, Ultrasound guided infraclavicular block