Comparison of 90° and 120° Arm Positions in Costoclavicular Block
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-80
SponsorAnkara Etlik City Hospital
About this trial
The costoclavicular approach of the infraclavicular brachial plexus block is widely used for upper extremity surgeries due to its reliable anatomy and high success rates. Patient positioning, particularly the degree of arm abduction, may influence the spread of local anesthetic and the characteristics of the block. However, the optimal arm abduction angle during this procedure remains unclear.
This prospective randomized controlled trial aims to investigate the effect of two different arm abduction angles (90° and 120°) on block onset time and block success in patients undergoing hand, wrist, and forearm surgery under ultrasound-guided costoclavicular brachial plexus block.
Patients will be randomly assigned to one of two groups according to the degree of arm abduction. The primary outcome is block onset time. Secondary outcomes include block success, sensory and motor block characteristics, perfusion index changes, hemodynamic parameters, readiness for surgery at 15 and 20 minutes, block performance time, need for additional anesthesia, postoperative neurological evaluation at 4 and 24 hours, complications, and patient satisfaction.
The findings of this study are expected to provide evidence on optimal patient positioning to improve the effectiveness and reliability of ultrasound-guided costoclavicular brachial plexus block.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Patients aged between 18 and 80 years.
Patients scheduled for elective upper extremity surgery (hand, wrist, forearm).
Patients classified as ASA I-III.
Patients who provide informed consent after being informed about the study.
Disqualifiers
History of previous surgery, scar tissue, tumor, or trauma that may alter brachial plexus anatomy.
Presence of infection, hematoma, severe edema, burn, or open wound at the block application site.
Known allergy to local anesthetics or other medications used in the study.
Coagulopathy, use of anticoagulants, or platelet count < 100,000/mm³.
Trial design
Design model
Parallel
Treatments tested in this trial
Costoclavicular Brachial Plexus Block
Procedure/SurgeryUltra-sound Guided costoclavicular brachial plexus block performed for upper extremity surgery using a standard local anesthetic technique
Treatment groups
106 Participants
are divided into 2 treatment groupsGroup A: 90° Arm AbductionExperimental treatment 1 intervention
Group B: 120° Arm AbductionExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Block Onset Time
Time from completion of local anesthetic injection to achievement of adequate sensory block sufficient for surgery, assessed by pinprick test.
Time frame
Up to 30 minutes after block performanceSecondary outcomes
1
Block Success
Successful completion of surgery without the need for additional anesthesia.
Time frame
İntraoperative period2
Sensory Block Score
Sensory block was assessed using a 3-point pinprick scale ( 0= normal sensation, 1= loss of pinprick sensation, 2= complete sensory block).
Time frame
Baseline and at 5-minute intervals up to 20 minutes after block performance.3
Motor Block Score
Motor block was assessed using a 3-point motor scale (0= normal motor function, 1= reduced motor strength, 20 complete motor block).
Time frame
Baseline and at 5-minute intervals up to 30 minutes after block performance.4
Perfusion Index
Perfusion index values measured using a Masimo pulse oximeter probe placed on the blocked upper extremity.
Time frame
Baseline and at 5,10,15 and 20 minutes after block performance.Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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