Tourniquet Pain Prevention During Dista… | Clinical Trial

Key information

Conditions

Analgesia Agnosia Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms

Age range

21 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Post-tourniquet pain remains a common problem. It disturbs the quality of anesthesia during brachial plexus block for distal upper-limb surgery. Current evidence shows that adding an intercostobrachial nerve block using the landmark-based technique can improve analgesia for medial upper-arm procedures. The serratus anterior plane block has also been proposed as an adjunct that may cover the intercostobrachial nerve territory. However, the landmark intercostobrachial nerve technique relies on a blind injection and may give inconsistent results. Moreover, high-quality head-to-head data comparing ultrasound-guided intercostobrachial nerve block with serratus anterior plane block for tourniquet pain prevention are lacking.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Elective unilateral distal upper-limb surgery (hand, wrist or forearm) with use of pneumatic upper-arm tourniquets under ultrasound-guided brachial plexus block.

Exclusion criteria

Coagulopathy or therapeutic anticoagulation.
Local infection at injection sites.
Chronic opioid dependence.

Treatment and study plan

Selective ultrasound guided Intercostobrachial nerve block

Procedure

The patient will be positioned supine with the ipsilateral arm abducted. The ultrasound transducer will be positioned in the axilla along the mid-axillary line to visualize the thoracodorsal artery and vein and the fascia between the latissimus dorsi and serratus anterior muscles. The Intercostobrachial nerve often appears as a small hyperechoic structure lateral to the thoracodorsal vessels.

Serratus Anterior Plane Block

Procedure

The ultrasound transducer will be placed at the mid-axillary line at the level of the fourth or fifth rib to identify and inject a local anaesthetic drug in the plane between the latissimus dorsi and serratus anterior muscles.

Primary outcomes

Tourniquet pain degree

Time frame: The first 60 minutes of tourniquet inflation.

The visual analogue score of tourniquet pain at the end of first 60 minutes of tourniquet inflation with score 10 indicates worst pain and score 0 indicates no pain.

Secondary outcomes

Duration of tourniquet application.

Time frame: The first 2 hours intraoperative.

The time from tourniquet inflation to tourniquet deflation.

Study contacts

Contact information is provided by the study sponsor or research team.

Ahmed Mohamed Hassan

CONTACT

11 13930038 ext. +20

Mohamed Mohamed, MD

CONTACT

[email protected]

203350873 ext. 01

Sponsors and collaborators

Lead sponsor

Zagazig University

Other Gov

Registry information

Official study title

Brachial Plexus With Intercostobrachial Nerve or Serratus Anterior Plane Block for Tourniquet Pain Prevention During Distal Upper-Limb Surgery

Important dates

Study start: 2026
Primary completion: 2027
Study completion: 2027
First posted: Aug 25, 2026
Registry last updated: Aug 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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