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NCT Number: NCT07823738

Classic Versus Interfascial Axillary Block in Hand, Wrist, and Forearm Surgery

Hand, wrist, and forearm surgeries are commonly performed procedures with significant postoperative pain potential. Regional anesthesia of the brachial plexus via the axillary approach is one of the gold-standard techniques for distal upper-limb surgery. In the conventional (classic) axillary block, the median, ulnar, and radial nerves within the axillary sheath are individually targeted under ultrasound guidance; however, anatomical septations around the axillary artery may prevent homogeneous spread of local anesthetic, leading to a patchy block and reduced intraoperative success.

The interfascial axillary block is a modified approach in which local anesthetic is deposited into the fascial planes between the axillary muscles rather than directly into the nerve sheath, aiming for passive diffusion, homogeneous spread, and fewer needle manipulations. This prospective, randomized, single-center study compares the classic axillary block with the interfascial axillary block in patients undergoing hand, wrist, and forearm surgery, primarily in terms of surgical anesthesia adequacy (block success).

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Key information

Conditions

Nerve Block Regional Anesthesia Upper Extremity Surgery

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bursa Yuksek Ihtisas Training and Research Hospital

Bursa, 16110, Turkey (Türkiye)

About this study

This is a prospective, randomized, single-center clinical trial conducted in a Department of Anesthesiology and Reanimation. Randomization is performed using the sealed-envelope method. A total of 110 patients (55 per group) aged 18-90 years, American society of anesthesiologists physical status I-III, scheduled for elective hand, wrist, or forearm surgery under ultrasound-guided regional anesthesia will be enrolled.

Group 1 (Classic Axillary Block) receives an ultrasound-guided block targeting the median, ulnar, and radial nerves perineurally/perivascularly within the axillary sheath. Group 2 (Interfascial Axillary Block) receives an ultrasound-guided injection of local anesthetic into the potential fascial planes between the axillary muscles, relying on passive diffusion.

The primary outcome is surgical anesthesia adequacy (block success). Secondary outcomes include block application time, sensory and motor block onset, rates of additional local infiltration and conversion to general anesthesia, intraoperative additional analgesic/sedation requirements, hemodynamic parameters, patient and surgeon satisfaction, and complications.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Aged 18-90 years
  • American society of anesthesiologists physical status I-II-III
  • Scheduled for elective hand, wrist, or forearm surgery
  • Written informed consent obtained

Exclusion criteria

  • History of local anesthetic allergy
  • Coagulation disorder
  • BMI > 40 kg/m²
  • Infection at the block site
  • Chronic pain syndrome
  • Pregnancy
  • Inability to communicate
  • Need for emergency surgery

Treatment and study plan

Classic Axillary Block

Procedure

Classic (perivascular/perineural) axillary brachial plexus block

Interfascial Axillary Block

Procedure

Interfascial (fascial-plane) axillary brachial plexus block.

Primary outcomes

  1. Surgical anesthesia adequacy (block success)

    Time frame: 30 minutes after block

    Complete sensory and motor blockade of the surgical field, allowing the operation to be completed without additional local infiltration or conversion to general anesthesia

Secondary outcomes

  1. Block application time

    Time frame: intraoperative

    time from needle insertion to withdrawal.

  2. Sensory block onset time

    Time frame: 5., 10., 15., 30. minutes

    Pin-Prick test in the median, ulnar, radial, and musculocutaneous dermatomes (0: normal, 1: blunt, 2: no sensation).

  3. Motor block onset time

    Time frame: 5., 10., 15., 30. minutes

  4. Intraoperative additional analgesic/sedation consumption

    Time frame: intraoperative

  5. Patient and surgeon satisfaction

    Time frame: 2nd day after surgery

    4-point Likert scale (1: very poor, 4: very good)

Study contacts

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

Korgün Ökmen, PhD.

CONTACT

[email protected]

05057081021

Sponsors and collaborators

Lead sponsor

Bursa Yuksek Ihtisas Training and Research Hospital

Other Gov

Registry information

Official study title

Comparison of Axillary Block and Interfascial Axillary Block in Terms of Block Success and Intraoperative Clinical Efficacy in Hand, Wrist, and Forearm Surgery: A Prospective Randomized Study

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 16, 2026
Registry last updated
Sep 21, 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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