NCT04370184

USG Imaging of Brachial Plexus Sheath & Its Fascial Compartments at Costoclavicular Space & Infraclavicular Fossa

Completed Last updated 27 January 2021

What this trial tests

trial testing Ultrasound guided Costoclavicular Brachial Plexus Block in Musculoskeletal Diseases or Conditions in 100 participants. Completed in 31 December 2020.

Timeline

1 June 2020

Primary endpoint
31 December 2020

31 December 2020

Quick facts

Lead sponsor	Chinese University of Hong Kong
Status	Completed
Study type	OBSERVATIONAL
Enrollment	100
Start date	1 June 2020
Primary completion	31 December 2020
Estimated completion	31 December 2020
Sites	1 location across Hong Kong

Drugs / interventions tested

• Ultrasound guided Costoclavicular Brachial Plexus Block

Conditions studied

• Musculoskeletal Diseases or Conditions — all drugs for Musculoskeletal Diseases or Conditions →

Sponsor

Chinese University of Hong Kong

Who can join

Adults 18 to 70, any sex, with Musculoskeletal Diseases or Conditions. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

The existence of the brachial plexus sheath (BPS) and its septae and compartments has been a subject of debate and controversy. Numerous cadaver studies indicate that BPS is present while other researchers based on limited clinical data suggest none. Nevertheless, cumulative evidence over the last six decades indicate that it is multi-layered, fibrous and a web-like connective tissue that is derived from the deep cervical fascia and fused with the deep fascia of the arm The BPS completely envelopes that neurovascular bundle and filed with loose connective tissue and fat. It is a multi-compartment structure in the axilla with each nerve having a separate compartment, that communicate with each other. Some studies suggested that the septae affect the spread of local anesthetic during an axillary or infraclavicular brachial plexus block, while some suggest the opposite. With the use of ultrasound imaging, researchers found the presence of this connective tissue septum within the BPS at the costoclavicular space and infraclavicular fossa. The septum is visualized as a linear hyperechoic band on ultrasound imaging and when present appears to reduce the spread of the drugs during brachial plexus block. Yet the anatomy is poorly seen with the previous generation of ultrasound imaging. The aim of this study is to define the connective tissue (fascial) layers that surround the brachial plexus and its septum at the infraclavicular fossa by reviewing our archived high definition ultrasound images of 100 patients who had successfully undergone the ultrasound guided brachial plexus block over a 5 year period (2013 to 2018).

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. High-definition ultrasound imaging defines the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa.
   Areeruk P, Karmakar MK, Reina MA, Mok LYH, et al · · 2021 · cited 18× · PMID 33811182 · DOI 10.1136/rapm-2020-102304