Ultrasound Guided Intercostobrachial Nerve Block

Study Overview
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Brief Summary
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The intercostobrachial nerve underlies many anatomical variations. For surgery of the upper arm the axilla is usually not anaesthetized by a brachial plexus block, which therefore needs to be completed by an intercostobrachial nerve block. The optimal access for an ultrasound guided block of the intercostobrachial nerve is not yet known. The investigators compare a proximal and a more distal approach to the nerve referred to onset time, sensory blocked area and duration.

Detailed Description
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The participants will be randomized into two groups: Group one receives a modified PECS 2 (thoracic wall) block above the second intercostal space with injection between the Musculus serratus anterior and Musculus pectoralis minor. Group 2 receives a subpectoral block under the pectoralis major muscle at the medial boarder of the axillary triangle.

Official Title
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Area of Sensory Loss, Onset Time and Duration of Two Different Ultrasound Guided Intercostobrachial Nerve Blocks for Vascular Access Surgery of the Upper Arm

Conditions
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Anaesthesia

Intervention / Treatment
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* Drug: 10ml ropivacain 0.5%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients planned for vascular access surgery of the upper arm surgery planned under regional anaesthesia Exclusion Criteria: patients refusal age under 18 allergy against local anaesthetics polyneuropathies

Ages Eligible for Study
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Minimum Age: 18 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 |
| --- | --- |
| Active Comparator: Anterior musculus serratus block<br>Proximal nerve block above the second intercostal space between Musculus serratus anterior and Musculus pectoralis minor. Intervention: 10ml ropivacain 0.5% | Drug: 10ml ropivacain 0.5%<br>* Ultrasound guided nerve block<br>* Other names: ropivacain Sintetica 0.5%;|
| Active Comparator: Subpectoral block<br>Distal nerve block under the Musculus pectoralis major at the medial border of the axillary triangle. Intervention: 10ml ropivacain 0.5% | Drug: 10ml ropivacain 0.5%<br>* Ultrasound guided nerve block<br>* Other names: ropivacain Sintetica 0.5%;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blocked area in squared cm | Area of sensory loss to pin prick test | Assessment 30 minutes after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Block onset time in minutes | Onset time of complete analgesia. Assessment by pin prick test in the middle of the axilla | Complete timeframe of 45 minutes with testing every 5 minutes | 
| Block duration in minutes | Complete analgesia to pin prick in the middle of the axilla | Assessment every 30 minutes for 8 hours after nerve block | 
| The pain numeric rating scale (NRS) during surgical manipulation in the axilla |  | From beginning to end of surgery. Estimated mean duration of 90 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Peripheral Nerve Block