NCT02331030

A Randomised Trial Comparing Supraclavicular Block vs Supraclavicular and Pecs II Block in Arteriovenous Grafting

A Randomised Controlled Trial Comparing Ultrasound-guided Supraclavicular Brachial Plexus Block With Combined Supraclavicular and Pecs II Block in Patients Undergoing Arteriovenous Grafting Surgery

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 36 (actual)
• Sponsor: Changi General Hospital · Academic / Other
• Sex: All
• Age: 21 Years – 90 Years
• Healthy volunteers: Not accepted

Summary

This study evaluates the addition of Pecs II block to ultrasound-guided supraclavicular brachial plexus block in patients undergoing arteriovenous graft creation surgery. Participants will be randomised into two equal groups, one receiving supraclavicular and pecs II blocks, the other receiving supraclavicular block and sham block (Grade 1).

Detailed description

Regional anaesthesia (RA) for arteriovenous grafting surgery has advantages of avoiding risks of general anaesthesia (GA) in this group of patients with significant co-morbidities, and beneficial vasodilatation, which may prevent early fistula thrombosis. Hence, RA is preferable to GA for this surgery. Brachial plexus blocks (BPB) are the most commonly employed RA technique to anaesthetise the upper limb for this surgery. According to the results of a recent 2-year retrospective audit in our centre, ultrasound-guided supraclavicular BPB are the most popular RA technique for this surgery. Anatomically, the T1 and T2 dermatomes are often missed by the supraclavicular BPB. This means that the upper medial arm and axilla (sites involved in brachiobasilic and brachioaxillary arteriovenous grafting) may not be adequately anaesthetised, mandating intraoperative local anaesthetic supplementation by the surgeon. This may affect patients' and surgeons' acceptance of, and satisfaction with the RA technique. The ultrasound-guided Pecs II block, described by Blanco et al, seems to address this problem, as the intercostal T1-6, intercostobrachialis, long thoracic nerves and nerve to serratus anterior are targeted by this block.

Conditions

• Arteriovenous Fistula
• Arteriovenous Graft
• Kidney Failure, Chronic
• Renal Failure, End-stage

Interventions

Type	Name	Description
PROCEDURE	Supraclavicular	Ultrasound-guided supraclavicular brachial plexus block
PROCEDURE	Pecs II block	Ultrasound guided interfascial plane block between pectoralis minor and serratus anterior
PROCEDURE	Sham block (Grade 1)	Sham block -- with skin preparation, ultrasound scanning of pecs II block area, but no actual needle injection
DRUG	Ropivacaine 0.5% 20ml	Local anaesthetic solution administered for supraclavicular block
DRUG	Ropivacaine 0.5% 10ml	Local anaesthetic solution administered for pecs II block

Timeline

• Start date: 2014-12-01
• Primary completion: 2016-12-01
• Completion: 2016-12-01
• First posted: 2015-01-05
• Last updated: 2017-07-19

Locations

1 site across 1 country: Singapore