Bupivacaine diluted with D5W versus saline for infraclavicular brachial plexus block

The Effect of Diluting Bupivacaine With 5% Dextrose and 0.9% NaCl on Block Success and Duration of Analgesia in Infraclavicular Block

This will test whether diluting bupivacaine with D5W (5% dextrose) instead of normal saline makes the infraclavicular nerve block start faster or provide longer pain relief after upper-arm surgery.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 90 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Sakarya University (Academic / other)
• Locations: 1 site (Sakarya)
• Trial ID: NCT07386327 on ClinicalTrials.gov

What this trial studies

This interventional study compares two common diluents—D5W (5% dextrose) and 0.9% sodium chloride—for bupivacaine used in ultrasound-guided infraclavicular brachial plexus blocks for elective upper-extremity surgery. Participants who meet inclusion criteria will receive bupivacaine prepared with one of the two diluents, and investigators will record measures such as block onset time, block success, and duration of postoperative analgesia. The rationale builds on prior reports that D5W can alter perineural mechanics and neurogenic inflammation and may influence local anesthetic spread and effect. Safety monitoring will follow standard perioperative anesthesia protocols.

Who should consider this trial

Good fit: Adults aged 18–65, ASA physical status I–III, scheduled for elective upper-extremity surgery suitable for an infraclavicular block, with a normal neurologic exam and meeting weight/BMI criteria, are the intended participants.

Not a fit: Patients with BMI ≥ 30, significant cardiac disease, coagulopathy, hepatic failure, pregnancy, allergy to study medications, or other listed exclusions are unlikely to participate or benefit from this protocol.

Why it matters

Potential benefit: If successful, this could lead to faster block onset or longer postoperative pain control with a simple change in diluent, improving anesthesia care for upper-extremity surgery.

How similar studies have performed: Previous clinical work and randomized studies in peripheral nerve hydrodissection and some regional anesthesia reports suggest D5W can affect pain and block characteristics, but direct head-to-head evidence for infraclavicular blocks is limited.

Eligibility criteria

Inclusion Criteria:

* Patients who agree to participate in the study and provide written informed consent
* Patients scheduled for elective upper extremity surgery for whom infraclavicular block is considered appropriate for anesthetic management
* Age between 18 and 65 years
* American Society of Anesthesiologists (ASA) physical status I-III
* Patients with a normal neurological examination in the extremity scheduled for peripheral nerve block

Exclusion Criteria:

* Patients who decline to participate in the study or refuse to provide informed consent
* History of allergy or hypersensitivity to study medications
* Body mass index (BMI) ≥ 30 kg/m²
* Body weight less than 40 kg
* Age below 18 years or above 65 years
* History of significant cardiac disease (e.g., arrhythmia, conduction disorders)
* Presence of coagulopathy (international normalized ratio \[INR\] \> 1.5 and/or platelet count \< 100,000/mm³)
* Hepatic failure or significant liver dysfunction
* Pregnant patients
* Infection at the planned peripheral block site
* Presence of neurological deficit in the extremity planned for peripheral nerve block
* Patients with uncontrolled diabetes mellitus and/or established diabetic neuropathy
* American Society of Anesthesiologists (ASA) physical status IV

Where this trial is running

Sakarya

• Sakarya University-Anesthesiology and Reanimation Department — Sakarya, Turkey (Türkiye) (Recruiting)

Study contacts

• Study coordinator: Burçin Alaçam

Conditions Infraclavicular Brachial Plexus Block; Dextrose; Bupivacaine; Block Success; Postoperative Analgesia