Infraclavicular Brachial Plexus Block

This prospective observational study aims to evaluate the time-dependent changes in Pulse Wave Transit Time (PWTT) following ultrasound-guided infraclavicular brachial plexus block. PWTT is a non-invasive hemodynamic parameter reflecting vascular tone and sympathetic nervous system activity. Patients undergoing upper extremity surgery under infraclavicular block will be monitored using standard perioperative monitoring devices. PWTT measurements will be obtained before and after block placement at predefined time intervals. Secondary outcomes will include perfusion index, skin temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation. The study seeks to determine whether PWTT can serve as an objective and non-invasive marker of sympathetic blockade following infraclavicular block.

D5W) has long been used as an intravenous fluid for hydration and energy supplementation and has recently gained increasing clinical interest in perineural injection therapies and ultrasound-guided hydrodissection. D5W has been shown to improve pain and functional outcomes in entrapment neuropathies by mechanically releasing perineural adhesions and potentially modulating neurogenic inflammation. In contrast, 0.9% sodium chloride (normal saline) is routinely used as a dilution medium for local anesthetics in peripheral nerve blocks; however, emerging evidence suggests that alternative diluents such as D5W may influence block onset and efficacy. The infraclavicular block is a commonly used ultrasound-guided technique for brachial plexus anesthesia, providing reliable anesthesia and postoperative analgesia for upper extremity surgery. This study aims to compare the effects of diluting bupivacaine with either D5W or 0.9% NaCl on block success and duration of analgesia in patients undergoing infraclavicular block. Secondary outcomes include block onset characteristics, sensory and motor block profiles, and perioperative analgesic requirements. The findings may help determine whether D5W represents a safe and effective alternative diluent to saline in routine regional anesthesia practice.