Efficacy of Variable Volume Truncal Blocks in Upper Limb Orthopedic Surgery
Comparison of the Anesthetic and Analgesic Efficacy of Selective Truncal Blocks at Different Volumes in Upper Extremity Orthopedic Surgeries
Gaziosmanpasa Research and Education Hospital
60 participants
Nov 1, 2024
INTERVENTIONAL
Conditions
Summary
aim of this study is to compare the effect of selective truncal blocks, performed at different doses and volumes, on the onset times of motor and sensory blocks required for anesthesia in patients scheduled for hand, wrist, forearm, and elbow surgeries. Completing the operation under regional anesthesia will be considered a successful block.
Eligibility
Inclusion Criteria3
- ASA 1-2
- Body Mass Index (BMI) of 18-35 kg/m²
- Age: 18-65 years -Patients undergoing all upper extremity orthopedic surgeries, except shoulder surgeries (distal humerus, elbow, forearm, hand, and wrist), will be included. -
Exclusion Criteria13
- Patient refusal
- Pregnancy or breastfeeding
- Severe pulmonary disease
- Contralateral diaphragm paralysis
- Nerve injury secondary to trauma
- Neuromuscular disease
- Peripheral neuropathy
- Bleeding diathesis
- Allergy to local anesthetics and dexamethasone
- Uncontrolled diabetes mellitus
- Morbid obesity with BMI >35
- Severe cardiovascular, renal, or hepatic disease
- Infection at the site of the nerve block
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Interventions
A high-frequency linear ultrasound (USG) probe will be used to locate the C7 transverse process, which will serve as a sonoanatomic landmark. Once the C5 ventral ramus is identified at the C7 transverse process level, the linear probe will be slightly caudally angled to visualize the C6 ventral ramus. The area where the superior trunk is formed by C5 and C6 will be examined with the USG probe until the superior trunk is visualized. Below the superior trunk, the middle trunk and the C8 ventral ramus will be visible. In Group 1, a total of 23 ml of 0.5% bupivacaine plus 2 ml (8 mg dexamethasone) will be used as the local anesthetic mixture, totaling 25ml. 7ml of the local anesthetic mixture will be injected into the superior trunk, the middle trunk for an additional 8 ml. The probe will then be directed caudally to obtain an optimal view of the lower trunk, where 10 ml of the same mixture will be injected close to the lower trunk.
In Group 2, 13 ml of 0.5% bupivacaine plus 2 ml (8 mg dexamethasone) will be used, totaling 15 ml. In Group 2, 5 ml of the local anesthetic mixture will be injected into the superior trunk, followed by 5 ml into the middle trunk and 5 ml into the lower trunk, as in Group II.
Locations(1)
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NCT06664203