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Comparative Study of Subcoracoid Tunnel Block Versus Costoclavicular Block

ConditionDistal Upper Limb Surgeries
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age65-85
SponsorZagazig University

About this trial

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following the ultrasound-guided subcoracoid tunnel block or costoclavicular block for elderly patients undergoing distal upper limb surgeries.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients acceptance to share in the study.

Patients with ASA physical status I-II.

Patients with a body mass index (BMI): of 18.5-30 kg/m2.

Patients undergoing distal upper limb surgeries not more than 2 hours.

Disqualifiers

Patients with a history of allergic reactions or contraindications to local anesthetics.

Patients with significant comorbidities (e.g., severe cardiovascular, neurological, or musculoskeletal disorders).

Patients with respiratory insufficiency.

Patients with coagulation disorders or taking drugs affecting surgical hemostasis.

Trial design

Design model

Parallel

Treatments tested in this trial

  • subcoracoid tunnel block

    Other intervention

    The probe will be placed with its proximal end towards the mid-clavicular point and distal end with a marker towards the apex of the axilla. A medial tilt of the probe will demonstrate the posterior and medial cords, while a slight lateral tilt of the probe will demonstrate the lateral cord. The needle entry point at the distal end of the probe will be marked. By using the in-plane technique, the needle will be advanced from a caudal to cephalad direction. The probe will be tilted medially, and the needle will be advanced to position its tip above the posterior or medial cord. The probe will be tilted laterally. The needle tip will be repositioned above the lateral cord, and the LA will be injected

  • Costoclavicular block

    Other intervention

    . The key anatomical structures will be identified under ultrasound: the pectoralis major muscle, subclavius muscle, and three brachial plexus cords (lateral, medial, and posterior) clustered tightly lateral to the axillary artery, along with the axillary artery and vein. The needle will be inserted by the in-plane technique from lateral to medial. The needle tip will be advanced through subcutaneous tissue and subclavius, aiming to land in the costoclavicular fascial plane between the cords, ideally between the lateral and posterior cords and superficial to the medial cord, without traversing neural structure by multipoint strategy, and local anesthesia will be injected.

Treatment groups

70 Participants
are divided into 2 treatment groups
Group A: Group (S)Active comparator 1 intervention
Group B: Group (C)Active comparator 1 intervention

Trial outcomes

Primary outcomes

1

the onset time of sensory block

the time interval between the end of total local anesthetic administration and complete sensory block

Time frame
5 minutes after the block

Secondary outcomes

1

block performance time

Time frame
time of performance of the block
2

3. Time of first rescue analgesia(naluphine)

Time frame
24 hours postoperative
3

Pain intensity

10-point NRS \[(0 = no pain, 10 = worst imaginable pain), 1-3: Mild pain (nagging, annoying, slightly interfering with activities of daily living (ADLs), 4 - 6: Moderate pain (significantly interfering with ADLs, 7 - 10: Severe pain (disabling, unable to perform ADLs)\]

Time frame
basal, one, 2, 4, 8, 12, 18, 24, and 24 hours postoperative
4

patient's satisfaction

The patients will be asked to rate the overall degree of satisfaction of the analgesia by using a 5-points likert-like verbal scale (1 = very dissatisfied analgesia, 2 = dissatisfied analgesia, and 3 = neutral, 4=satisfied analgesia, and 5=very satisfied analgesia)

Time frame
24 hours postoperative

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Zagazig University

Lead sponsor

Source ClinicalTrials.gov

This trial is not recruiting at the moment. You can still explore other options: