Comparing Two Injection Sites of Local Anesthetic for Hand Surgery

Study Overview
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Brief Summary
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The purpose of this study is to compare two different injection sites for local anesthesia in patients having hand surgery. The hypothesis is that subjects receiving injections around the three nerves of the forearm will provide faster pain control and greater patient satisfaction than patients having one injection closer to the shoulder.

Official Title
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A Comparison Of Distal Peripheral Nerve Blockade Versus Traditional Proximal Approaches For Hand Surgery

Conditions
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Hand Injury, Wrist Injury, Finger Injury

Intervention / Treatment
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* Procedure: 0.5% bupivacaine injected in the forearm
* Procedure: 20-30ml of 0.5% bupivacaine.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients ≥ 18 years of age undergoing unilateral hand, wrist, or finger surgery Ability to understand and provide informed consent American Society of Anesthesiologists (ASA) status I-III Exclusion Criteria: Patient refusal or inability to provide informed consent True allergy, not sensitivity, to any of the following substances: Local Anesthetics, Midazolam, Fentanyl, Hydromorphone, Propofol Pregnancy Severe hepatic impairment Evidence of infection at or near the proposed needle insertion site Any sensorimotor deficit of the ipsilateral upper extremity, whether acute or chronic, as determined by the PI and designee Pulmonary disease of any kind that is uncontrolled or severe in nature Chronic pain patients, defined as someone diagnosed with chronic pain or a chronic pain condition, under the care of a chronic pain physician, or taking oral/intravenous narcotics consistently for 30 days prior to surgery

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: distal injection<br>0.5% bupivacaine injected in the forearm | Procedure: 0.5% bupivacaine injected in the forearm<br>* Median, Ulnar, and Radial nerve blocks performed in the forearm<br>|
| Active Comparator: proximal injection<br>20-30ml of 0.5% bupivacaine | Procedure: 20-30ml of 0.5% bupivacaine.<br>* supraclavicular, infraclavicular, or axillary nerve block using 20-30ml of 0.5% bupivacaine.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| success of block | number of participants that needed additional anesthesia | up to 30 minutes after injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain scores | change in pain scores | up to 10 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anesthesia, hand surgery, wrist surgery, finger surgery, regional anesthesia, postoperative pain