--- title: Retroclavicular Approach vs Infraclavicular Approach for Plexic Bloc Anesthesia of the Upper Limb nct_id: NCT02913625 overall_status: COMPLETED phase: NA sponsor: Université de Sherbrooke study_type: INTERVENTIONAL primary_condition: Hand Injury countries: Canada canonical_url: "https://parkinsonspathways.com/agent/trials/NCT02913625.md" clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT02913625" ct_last_update_post_date: 2017-07-06 last_seen_at: "2026-05-12T06:01:39.985Z" source: ClinicalTrials.gov (mirrored, no enrichment) --- # Retroclavicular Approach vs Infraclavicular Approach for Plexic Bloc Anesthesia of the Upper Limb **Official Title:** Retroclavicular Approach vs Infraclavicular Approach for Plexic Bloc Anesthesia of the Upper Limb: a Multi-centric Non-inferiority Randomised Controlled Trial **NCT ID:** [NCT02913625](https://clinicaltrials.gov/study/NCT02913625) ## Key Facts - **Status:** COMPLETED - **Phase:** NA - **Study Type:** INTERVENTIONAL - **Target Enrollment:** 110 - **Lead Sponsor:** Université de Sherbrooke - **Conditions:** Hand Injury - **Start Date:** 2016-09 - **Completion Date:** 2017-06 - **CT.gov Last Update:** 2017-07-06 ## Brief Summary Locoregional anesthesia provides several advantages over general anesthesia in terms of postoperative pain, decreased postoperative opioid needs and reduced recovery time for patients undergoing orthopaedic surgery. For upper limb surgery, the coracoid infraclavicular brachial plexus block is generally preferred because of its simplicity and effectiveness but, needle visibility remains a challenge because of the angle between the ultrasound beam and the needle. The retroclavicular approach for brachial plexus anesthesia requires an angle between the needle and the ultrasound beam that is less steep than the angle required to perform an infraclavicular coracoid block. This approach has already been proven effective and safe in the past. The general objective is to provide a formal comparison between the retroclavicular approach and coracoid infraclavicular approach for brachial plexus anaesthesia. This study will delineate the differences between the two techniques. ## Detailed Description Investigators aim is to compare both techniques in terms of scanning time, needling time, total anesthesia time, needle visibility, block needle passes, block success and early and late complications. Investigators made the hypothesis that, while providing similar efficacy and better needle visualisation than coracoid infraclavicular block, performance time of retroclavicular block will not exceed the performance time of its comparator. This study is designed as a prospective randomized non-inferiority trial. Two groups of non-consecutive patients will be randomly assigned to either retroclavicular or coracoid infraclavicular block. This study will be carried out in three different centres simultaneously. The multicentre trial will be conducted in two university hospitals (Centre hospitalier universitaire de Sherbrooke \[CHUS\] Hôtel-Dieu/Fleurimont and Centre Hospitalier de l'Université Laval \[CHUL\] in Quebec city) and a community hospital (Cowansville). The third participating establishment, Brome-Missisquoi-Perkins hospital, is located in Cowansville, a peripheral city of 15,000 people. ## Eligibility - **Minimum age:** 18 Years - **Sex:** ALL - **Healthy Volunteers:** No ``` Inclusion Criteria: * Elective or urgent surgery of the hand, wrist, forearm or elbow. * Age \>18 years old. * ASA (American Society of Anesthesiologists) class 1, 2 and 3. * Able to provide valid written consent. * Minimum body weight of 50 kg, despite BMI Exclusion Criteria: * Patient refusal. * Previous surgery or gross anatomical deformity of the clavicle. * Systemic or local infection at needle entry point. * Coagulopathy. * Severe pulmonary condition. * Local anaesthetic allergy. * Pre-existing neurologic symptoms in the ipsilateral limb. * Pregnancy. * Surgical request of an indwelling catheter for post-operative analgesia ``` ## Arms - **Ultrasound guided retroclavicular block** (EXPERIMENTAL) — Patients assigned to this group will receive an ultrasound guided retroclavicular brachial plexus block - **Ultrasound guided infraclavicular block** (ACTIVE_COMPARATOR) — Patients assigned to this group will receive an ultrasound guided infraclavicular brachial plexus block ## Interventions - **Ultrasound guided retroclavicular block** (OTHER) — Ultrasound guided retroclavicular block for forearm or hand surgery - **Ultrasound guided infraclavicular block** (OTHER) — Ultrasound guided infraclavicular block for forearm or hand surgery ## Primary Outcomes - **Time of block performance** _(time frame: Measured directly during the procedure with a chronometer. Time of performance is composed of imaging time and needling time)_ — The performance time corresponds to the sum of imaging time and needling time. It is expressed in minutes. Analysis of the primary outcome: performance time will be analyzed with a non-inferiority test of the averages, with the objective of finding that the experimental retroclavicular approach is no longer to perform than the coracoid infraclavicular approach. Subgroup analysis will be conducted to evaluate if higher body mass index influence (BMI) the outcomes, as the performance time, the needle visibility, the number of needle passes and the needle angle. Patient will be divided in two groups (higher and lower than the average BMI of all recruited patients) and analyzed according to their subgroup. If data is missing or if patient drop-out occurs, data will be analyzed with the intention-to-treat principle. ## Secondary Outcomes - **Imaging time** _(time frame: Measured directly during the procedure with a chronometer.)_ - **Needling time** _(time frame: Measured directly during the procedure with a chronometer.)_ - **Time to sensory loss evaluated at 10, 20 and 30 minutes after procedure** _(time frame: Blind assistant evaluates the loss of sensibility in 5 precise nerve territories, 10, 20 and 30 minutes after the block.)_ - **Time to motor blockade evaluated at 10, 20 and 30 minutes after procedure** _(time frame: Blind assistant evaluates the loss of motor function in four muscular groups at 10, 20 and 30 minutes after the block.)_ - **Success of plexus block** _(time frame: Success is defined at end of surgery for which block was done, generally within 1 to 3 hours after block is performed)_ - **Total anesthesia time** _(time frame: Intraoperative)_ - **Number of needle passes** _(time frame: Number of needle passes required during procedure.)_ - **Needle visualization** _(time frame: Assessed one week after study completion)_ - **Needle angle** _(time frame: Assessed one week after study completion)_ - **Neurostimulation use** _(time frame: Assessed during the block)_ - **Pain during the procedure** _(time frame: Patients will be asked to report the level of discomfort they felt during the procedure)_ - **Early and late complications:** _(time frame: Assessed during each block and again at 48 hours after the block)_ ## Locations (2) - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada - Centre Hospitalier de l'Université Laval [CHUL], Québec, Canada ## Recent Field Changes (last 30 days) - `status.overallStatus` — added _(2026-05-12)_ - `status.primaryCompletionDate` — added _(2026-05-12)_ - `status.completionDate` — added _(2026-05-12)_ - `status.lastUpdatePostDate` — added _(2026-05-12)_ - `design.phases` — added _(2026-05-12)_ - `design.enrollmentCount` — added _(2026-05-12)_ - `eligibility.criteria` — added _(2026-05-12)_ - `eligibility.minAge` — added _(2026-05-12)_ - `eligibility.sex` — added _(2026-05-12)_ - `outcomes.primary` — added _(2026-05-12)_ - `outcomes.secondary` — added _(2026-05-12)_ - `armsInterventions.arms` — added _(2026-05-12)_ - `armsInterventions.interventions` — added _(2026-05-12)_ - `sponsor.lead` — added _(2026-05-12)_ - `results.hasResults` — added _(2026-05-12)_ - `locations.centre hospitalier universitaire de sherbrooke|sherbrooke|quebec|canada` — added _(2026-05-12)_ - `locations.centre hospitalier de l'université laval [chul]|québec||canada` — added _(2026-05-12)_ --- *Canonical: https://parkinsonspathways.com/agent/trials/NCT02913625.md* *Source data (authoritative): https://clinicaltrials.gov/study/NCT02913625* *This page is a raw mirror with no AI summary, no editorial enrichment, and no Parkinson's-specific filtering.*