Using Ultrasound in Infraclavicular in Upper Limb Surgeries

Study Overview
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Brief Summary
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Comparison of 3 approach of infraclavicular brachial plexus

Detailed Description
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Comparison of retroclavicular & costoclavicular and classic type of infraclavicular brachial plexus block for upper limb surgeries

Official Title
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Ultrasound Guided Retroclavicular Approach Versus Costoclavicular Approach of Infraclavicular Brachial Plexus Block for Upper Limb Surgeries

Conditions
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Upper Limb Surgeries

Intervention / Treatment
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* Procedure: Infraclavicular brachial plexus block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age: between 18 and 60 years ASA I and II BMI between 18 and 35 surgeries to forearm and hand Exclusion Criteria: patient refusal pregnancy allergy to local anaesthetics local infection neuropathy ,coagulopathy anatomical abnormality in clavicular region

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Retroclavicular<br>Retroclavicular approach to the infraclavicular region, the probe will be placed below and perpendicular to the clavicle, in a paramedian sagittal plane, medial to the coracoid process, to obtain a short-axis view of the cords of the brachial plexus and the axillary vessels. The needle will then be inserted in the supraclavicular fossa, approximately 1 cm posteriorly to the clavicle, and advanced in plane and strictly parallel to the ultrasound transducer. After passing the initial blind zone of about 2 cm caused by the acoustic shadow of the clavicle, the needle tip will be constantly seen, until it will be positioned posterior to the axillary artery. | Procedure: Infraclavicular brachial plexus block<br>* Using ultrasound in 3different techniques of infraclavicular brachial plexus block<br>|
| Active Comparator: Costoclavicular<br>A new approach to the infraclavicular block The ultrasound transducer will be placed parallel and inferior to the clavicle and angled cephalad to optimize the ultrasound view. The block needle will be inserted in-plane from a lateral to medial direction into the costoclavicular space and the entire drug will be deposited in this location | Procedure: Infraclavicular brachial plexus block<br>* Using ultrasound in 3different techniques of infraclavicular brachial plexus block<br>|
| Active Comparator: Classic<br>Infraclavicular brachial plexus block (ICPB) ultrasound probe will be placed near the lower edge of the clavicle, and a transverse view of the subclavian artery and vein will be visualized. Using a needle guide, the needle will be advanced under real-time ultrasound guidance, and local anaesthetic will be injected near the subclavian artery, 15 mm medially and 15 mm laterally to the artery. The extent of sensory and motor block will be evaluated at 30 minutes after the injection | Procedure: Infraclavicular brachial plexus block<br>* Using ultrasound in 3different techniques of infraclavicular brachial plexus block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor and sensory block success rate | Success rate 30 min after local anasthetic injections | 30 min |