USG Block of Cutaneous Nerves of the Arm

Study Overview
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Brief Summary
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For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN.

Detailed Description
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The primary objective of our study was to compare the effectiveness of conventional and USG blocks of the MBCN and the ICBN in the axillary fossa. Our hypothesis was that the proportion of patients with complete anesthesia in the entire posteromedial and anteromedial surface of the arm would be greater if a USG technique were used, compared with a conventional technique. The secondary objectives were onset time of complete anesthesia, volume of local anesthetic used for the procedure, tourniquet tolerance during surgery, and ultrasound visibility of MBCN and ICBN.

Official Title
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Ultrasound-Guided Plane Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves：A Retrospective Observational Study

Conditions
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Nerve Block

Intervention / Treatment
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* Procedure: Ultrasound-Guided Plane Block
* Procedure: Conventional Block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Surgery of the distal upper limb : hand, forearm, lower third of the arm ,including the elbow Urgent or planned surgery Locoregional anesthesia : axillary brachial plexus block, completed by a medial brachial cutaneous nerve block and an intercostobrachial nerve block Exclusion Criteria: Refused to sign informed consent Pregnant women Allergic to the local anesthetic

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Ultrasound-Guided<br>Ultrasound-Guided Plane Block | Procedure: Ultrasound-Guided Plane Block<br>* Ultrasound-Guided Plane Block Medial Brachial Cutaneous and the Intercostobrachial Nerves<br>|
| Conventional<br>Conventional Block | Procedure: Conventional Block<br>* Conventional Block Medial Brachial Cutaneous and the Intercostobrachial Nerves<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with complete anesthesia | Number of participants with complete anesthesia of the arm in region innervated by the MBCN and the ICBN | At time 20 minutes after the medial brachial cutaneous nerve and the intercostobrachial nerve block | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with complete anesthesia, with reduced sensitivity and with absence of anesthesia | Number of participants with complete anesthesia, with reduced sensitivity and with absence of anesthesia at times 5, 10, 15, 20 minutes (except primary outcome) in the areas of the medial brachial cutaneous nerve and the intercostobrachial nerve | At times 5, 10, 15, 20 minutes after the achievement of the medial brachial cutaneous nerve block and the intercostobrachial nerve block | 
| Volume of local anesthetic | The volume (in milliliters) of 1% lidocaine used for the medial brachial cutaneous nerve and the intercostobrachial nerve block | After nerve block immediately | 
| Tourniquet tolerance | Number of patients with comfortable feeling, with unpleasant sensations and with pains during surgery, in the areas of the medial brachial cutaneous nerve and the intercostobrachial nerve | 3 hours after the achievement of the medial brachial cutaneous nerve block and the intercostobrachial nerve block | 
| Good ultrasound view of theses nerves before and after the injection of the local anesthetic | Number of participants (of the ultrasound-guided group) with good ultrasound view of theses nerves before and after the injection of the local anesthetic | 5 minutes after the achievement of the medial brachial cutaneous nerve block and the intercostobrachial nerve block | 
| Bad ultrasound view of theses nerves before the injection and good ultrasound view of theses nerves after the injection of the local anesthetic | Number of participants (of the ultrasound-guided group) with bad ultrasound view of theses nerves before the injection and good ultrasound view of theses nerves after the injection of the local anesthetic | 5 minutes after the achievement of the medial brachial cutaneous nerve block and the intercostobrachial nerve block | 
| Bad ultrasound view of theses nerves before and after the injection of the local anesthetic | Number of participants (of the ultrasound-guided group) with bad ultrasound view of theses nerves before and after the injection of the local anesthetic | 5 minutes after the achievement of the medial brachial cutaneous nerve block and the intercostobrachial nerve block | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ultrasound-Guided Plane Block, Conventional Block