Costoclavicular versus lateral-sagittal infraclavicular block for hand and forearm surgery
Comparison Between Ultrasound-Guided Costoclavicular and Lateral-Sagittal Infraclavicular Brachial Plexus Blocks in Adult Distal Upper Limb Surgeries : A Randomized Controlled Trial
This study will see if the costoclavicular ultrasound-guided brachial plexus block produces a faster onset of numbness and motor block than the lateral-sagittal infraclavicular block in adults having hand or forearm surgery.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 50 (estimated) |
| Ages | 21 Years to 65 Years |
| Sex | All |
| Sponsor | Ain Shams University Academic / other |
| Locations | 1 site (Cairo) |
| Trial ID | NCT07517809 on ClinicalTrials.gov |
What this trial studies
This is a prospective randomized controlled comparison enrolling 50 adult patients undergoing distal upper limb surgery who receive one of two ultrasound-guided infraclavicular brachial plexus approaches. Participants are randomly assigned to a costoclavicular (CC) group or a lateral-sagittal infraclavicular (LS-ICB) group, with 25 patients per arm. Both groups receive the same local anesthetic mixture (2% lidocaine and 0.5% bupivacaine, 1:1 ratio) at 0.3 mL/kg under real-time ultrasound guidance. The primary outcome is time to onset of complete sensory and motor block, with safety and block quality monitored throughout.
Who should consider this trial
Good fit: Adults (ASA I–III) scheduled for distal upper limb surgery who can give written informed consent and have no pre-existing neuropathy, local infection, coagulopathy, severe pulmonary disease, allergy to study drugs, or BMI over 40 kg/m².
Not a fit: Patients with coagulopathy, active infection at the puncture site, severe pulmonary disease, pre-existing neurological deficit in the limb, allergy to the anesthetic drugs, or who refuse participation are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, the costoclavicular approach could provide faster block onset and more efficient anesthesia for hand and forearm surgery, improving patient comfort and operating-room workflow.
How similar studies have performed: Small studies and case series have reported promising results for the costoclavicular approach with clustered cords and rapid anesthetic spread, but randomized comparisons remain limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * ASA physical status I-III * Distal upper limb surgery requiring brachial plexus block. * Patient approval after written and informed consent to participate. Exclusion Criteria: * Patient refusal. * Allergy to drugs used. * Infection at puncture site. * Coagulopathy or anticoagulant therapy. * Pre-existing neuropathy or neurological deficit in the affected limb. * Severe pulmonary disease. * BMI \> 40 kg/m².
Where this trial is running
Cairo
- Ain Shams University Hospitals — Cairo, Egypt (Recruiting)
Study contacts
- Study coordinator: Ahmed Hesham Shahin, M.B.B.CH
- Email: 160634@med.asu.edu.eg
- Phone: +201270857308
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.