Patient Positioning on Supraclavicular Nerve Block
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 3/16/2015 |
| Start Date: | January 2012 |
| Contact: | Antoun Nader, MD |
| Email: | a-nader2@northwestern.edu |
| Phone: | 312/926-2280 |
Blockade of the brachial plexus using a supraclavicular approach provides excellent
anesthesia for upper extremity surgery. The most serious complication specific to this block
is pneumothorax. Subsequent modifications of this block including the use of ultrasound have
lowered the risk from 6% to <1%. Case reports remain and authors have described certain
factors and strategies to reduce this risk. Most texts and journals describe the patient in
a supine or semi-sitting position during the block. At the investigators institution the
investigators perform the block in a semi-sitting position to facilitate needle tip
visibility with ultrasound. The investigators plan to obtain ultrasound anatomic
measurements in three different positions (supine, semi-sitting, sitting) using patients
consented for supraclavicular nerve blocks.
anesthesia for upper extremity surgery. The most serious complication specific to this block
is pneumothorax. Subsequent modifications of this block including the use of ultrasound have
lowered the risk from 6% to <1%. Case reports remain and authors have described certain
factors and strategies to reduce this risk. Most texts and journals describe the patient in
a supine or semi-sitting position during the block. At the investigators institution the
investigators perform the block in a semi-sitting position to facilitate needle tip
visibility with ultrasound. The investigators plan to obtain ultrasound anatomic
measurements in three different positions (supine, semi-sitting, sitting) using patients
consented for supraclavicular nerve blocks.
Inclusion Criteria:
- all patients, 18 y/o to 65 y/o, who are scheduled to receive an ultrasound- guided
supraclavicular nerve block
Exclusion Criteria:
- patient refusal to be included in the study,
- the presence of language barrier that inhibits proper communication with the patient,
contraindications to regional anesthesia (local infection, severe pulmonary disease,
or preexisting neuropathy)
- history of allergy to amide local anesthetics or narcotics
- the presence of a progressive neurological deficit
- history of hepatorenal insufficiency
- the presence of a coagulopathy or infection
- pregnancy
- a history of psychiatric disorder
- inability to follow study protocol
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