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Supraclavicular Versus Combined Block for Ulnar and Median Distribution Hand Surgery

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01625208
Recruitment Status : Withdrawn (No participants enrolled)
First Posted : June 21, 2012
Last Update Posted : March 25, 2020
Information provided by (Responsible Party):
University of Alberta

Brief Summary:
This study will examine how successfully nerves are blocked or frozen for hand surgery. Traditionally, the nerves are frozen at the base of the neck, just above the clavicle or collarbone (the supraclavicular block). This is mostly successful by itself, and provides anesthesia of the entire arm. Occasionally, an additional nerve block is required further down the arm, as the supraclavicular block may have missed a segment, or it is taking too long to come on. In this study the investigators will compare the traditional technique, with a similar but lower volume supraclavicular block plus an immediate low volume block of one nerve further down the arm (the ulnar or median nerve block, depending on which digits are being operated on). The investigators will compare success rates, speed of onset, procedural comfort and length of time of weakness and numbness, plus any adverse events.

Condition or disease Intervention/treatment Phase
Hand Surgery (Ulnar or Median Distribution) Peripheral Nerve Block Procedure: Combined nerve block Procedure: Supraclavicular block Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Standard Supraclavicular Block Versus Low-Volume Supraclavicular Block Plus Ulnar or Median Nerve Block for Hand Surgery in the Ulnar or Median Nerve Distribution
Actual Study Start Date : March 2012
Actual Primary Completion Date : February 2013
Actual Study Completion Date : December 2013

Arm Intervention/treatment
Experimental: Combined nerve block
Participants in this group will receive a supraclavicular brachial plexus block plus a median or ulnar nerve block.
Procedure: Combined nerve block
Combined supraclavicular brachial plexus block plus ulnar or median nerve block (depending on the location of surgery)

Active Comparator: Single nerve block
Participants in this group will receive a supraclavicular brachial plexus block only.
Procedure: Supraclavicular block
Standard supraclavicular brachial plexus block

Primary Outcome Measures :
  1. Successful anesthesia, defined as no additional local anesthetic or heavy sedation required. [ Time Frame: From injection of local anesthetic to suitable nerve blockade for surgery; approximately 20 minutes ]
    Successful anesthesia will be determined by assessing the nerve block(s) following injection of local anesthetic, and deeming the block sufficient enough for surgery to proceed without any need for additional local anesthetic or heavy sedation. The period between the initial injection and successful anesthesia is approximately 20 minutes, depending on the patient.

Secondary Outcome Measures :
  1. Time to successful anesthetic block from withdrawal of final needle [ Time Frame: Approximately 20 minutes ]
    The period between final withdrawal of the needle to successful nerve block following assessment will be timed.

  2. Time for procedure, from placement of probe on skin to withdrawal of needle [ Time Frame: Approximately 30 minutes ]
    The period between initial placement and positioning of the ultrasound probe on the patient to final withdrawal of the needle will be timed.

  3. Duration of analgesia [ Time Frame: Approximately 6 hours ]
    The length of time between successful nerve block (i.e., when patient is ready for surgery) to the time the anesthesia wears off will be sought.

  4. Duration of motor blockade [ Time Frame: Approximately one hour ]
    The time taken for the patient to recover motor capability in the area anesthetized following local anesthetic injection will be determined.

  5. Patient satisfaction [ Time Frame: 24-48 hours ]
    Patient satisfaction with reduction of pain and recovery of motor capability will be assessed in the 24-48 hour period following surgery.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Over 18 years of age
  • Surgery on distal upper extremity amenable to a regional anesthetic involving the ulnar (ring, pinky fingers) or median (thumb, index, middle fingers) distribution.

Exclusion Criteria:

  • Patient refusal
  • Allergy to amide local anesthetics
  • Severe coagulopathy
  • Bilateral upper limb surgery
  • Surgery involving bone graft from the iliac crest
  • Request for general anesthetic from surgical or research team (for example, nerve stimulation studies)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01625208

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Canada, Alberta
University of Alberta Hospital
Edmonton, Alberta, Canada
Sponsors and Collaborators
University of Alberta
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Principal Investigator: James Cameron, MD University of Alberta

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Responsible Party: University of Alberta Identifier: NCT01625208    
Other Study ID Numbers: Pro00027213
First Posted: June 21, 2012    Key Record Dates
Last Update Posted: March 25, 2020
Last Verified: April 2015