Ultrasound Guidance Intercostobrachial Nerve Block in AVF Superficialization

ConditionsSupraclavicular Plexus Block Procedure (SCPB)ESRD

Trial statusNot yet recruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18-60

SponsorAssiut University

About this trial

The present clinical study will be undertaken to evaluate and compare the clinical efficacy of two different volumes of distal ICBN block when combined with a baseline supraclavicular brachial plexus block during superficialization of upper arm arteriovenous fistula

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult patients aged 18 to 65 years of either sex

Patients scheduled for elective upper-arm AVF superficialization (brachiobasilic or brachiocephalic)

ASA physical status II, III (common in chronic kidney disease patients)

Disqualifiers

Pre-existing peripheral neuropathy or severe neurological deficits in the operative upper extremity.

Cognitive impairment, psychiatric disorders, or an inability to comprehend and communicate the pain scoring scales

Patients on chronic opioid use

Local infection, severe dermatitis, or anatomical distortions at the proposed needle insertion sites.

Trial design

Design model

Parallel

Treatments tested in this trial

Distal Intercostobrachial Nerve Block
Procedure/Surgery
Ultrasound Positioning and Administration: The transducer will be placed transversely across the inner aspect of the arm, directly beneath where the pectoralis major muscle attaches. Infiltration Technique: Probe transversely across the axillary fold/proximal medial arm. Identify pectoralis major anteriorly and latissimus dorsi posteriorly. The target is the subcutaneous plane superficial to the brachial fascia, spanning between these muscular boundaries. Patients will be divided into two equal groups. Group H will be injected with 12 milliliters of bupivacaine 0.25%, and Group L will be injected with 6 milliliters of bupivacaine 0.25%, while advancing the needle so the LA forms a continuous subcutaneous spread from the pectoralis major side toward the latissimus dorsi side
Supraclavicular Plexus Block Procedure (SCPB)
Procedure/Surgery
supine with the head turned approximately 30° away from the surgical side, and a small towel will be positioned between the scapulae to optimize access. After aseptic preparation, a high-frequency linear US probe (6 - 12 MHz) covered with a sterile sheath will be placed in the coronal-oblique plane just superior to the clavicle and lateral to the sternocleidomastoid muscle to visualize the subclavian artery medially, the brachial plexus divisions as a cluster of hypoechoic round structures lateral to the artery, and the first rib and pleura as hyperechoic lines deep to the artery. Using an in-plane lateral-to-medial approach, a 22-G, 80-mm insulated block needle will be advanced under continuous US guidance toward the "corner pocket" bordered by the subclavian artery medially, the first rib inferiorly, and the brachial plexus laterally. After negative aspiration, Ten mL of bupivacaine 0.3% will be injected into the corner pocket. needle will be redirected to deposit additional 3 - 5 mL

Treatment groups

76 Participants

are divided into 2 treatment groups

Group A: Distal Intercostobrachial Nerve Block with large vloumeExperimental treatment 1 intervention

Group B: Distal Intercostobrachial Nerve Block with small vloumeExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

Comparing the incidence of successful complete sensory block

successful complete sensory block between the two techniques at 30 minutes after injection using cold sensitivity test.

Time frame

baseline

Locations

This trial has no locations.

Sponsors and contacts

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

Assiut University

Lead sponsor

Source ClinicalTrials.gov

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