Comparative Study of Subcoracoid Tunnel Block Versus Costoclavicular Block

Official title

Regional Anesthesia for Elderly Patients Undergoing Distal Upper Limb Surgeries: A Randomized Comparative Study of Subcoracoid Tunnel Block Versus Costoclavicular Block

Overview

The purpose of this study is to compare the analgesic outcomes (time to first analgesic request, total amount of analgesic consumption, and pain scores) following the ultrasound-guided subcoracoid tunnel block or costoclavicular block for elderly patients undergoing distal upper limb surgeries.

Interventions

• Other subcoracoid tunnel block
  The probe will be placed with its proximal end towards the mid-clavicular point and distal end with a marker towards the apex of the axilla. A medial tilt of the probe will demonstrate the posterior and medial cords, while a slight lateral tilt of the probe will demonstrate the lateral cord. The needle entry point at the distal end of the probe will be marked. By using the in-plane technique, the needle will be advanced from a caudal to cephalad direction. The probe will be tilted medially, and
• Other Costoclavicular block
  . The key anatomical structures will be identified under ultrasound: the pectoralis major muscle, subclavius muscle, and three brachial plexus cords (lateral, medial, and posterior) clustered tightly lateral to the axillary artery, along with the axillary artery and vein. The needle will be inserted by the in-plane technique from lateral to medial. The needle tip will be advanced through subcutaneous tissue and subclavius, aiming to land in the costoclavicular fascial plane between the cords, id

Primary outcome measures

• the onset time of sensory block [Time frame: 5 minutes after the block]

Secondary outcome measures (5)

• block performance time [Time frame: time of performance of the block]
• 3. Time of first rescue analgesia(naluphine) [Time frame: 24 hours postoperative]
• Pain intensity [Time frame: basal, one, 2, 4, 8, 12, 18, 24, and 24 hours postoperative]
• patient's satisfaction [Time frame: 24 hours postoperative]
• Incidence of block complications [Time frame: first 24 hours postoperative]

Eligibility criteria

Inclusion criteria

• Patients acceptance to share in the study.
• Patients with ASA physical status I-II.
• Patients with a body mass index (BMI): of 18.5-30 kg/m2.
• Patients undergoing distal upper limb surgeries not more than 2 hours.

Exclusion criteria

• Patients with a history of allergic reactions or contraindications to local anesthetics.
• Patients with significant comorbidities (e.g., severe cardiovascular, neurological, or musculoskeletal disorders).
• Patients with respiratory insufficiency.
• Patients with coagulation disorders or taking drugs affecting surgical hemostasis.
• Patients with pre-existing neurological deficits

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Egypt · 1 center

• faculty of medicine,zagazig university Egypt — Zagazig

Publications

• Kaya S, Sahap M, Demirtas K. Comparison of costoclavicular and lateral sagittal infraclavicular approaches in ultrasound-guided brachial plexus block. Agri. 2025 Jan;37(1):32-41. doi: 10.14744/agri.2024.34022. PMID 39835953

Identifiers

NCT: NCT07305584 · ZU-IRB#1885/7-Nov-2025

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗