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NCT Number: NCT07092891

Early Detection of Supraclavicular Brachial Plexus Block Failure Using Infrared Thermography and Perfusion Index

Successful peripheral nerve blockade is fundamental to modern regional anesthesia, particularly for upper limb surgeries. Ensuring the efficacy of a nerve block early in the perioperative period is critical, as delayed recognition of block failure may lead to intraoperative pain, the need for additional sedation or general anesthesia, and overall poorer patient outcomes. Conventional methods for assessing block success, such as sensory testing with pinprick or cold stimuli and motor assessment using strength scales, require patient cooperation and often take 15-30 minutes to yield definitive results. These delays are especially limiting in fast-paced surgical environments or when early decisions regarding anesthesia management are necessary.

Emerging non-invasive monitoring technologies offer promising alternatives for the early, objective assessment of block efficacy. Infrared Thermography (IRT) measures skin surface temperature, which increases due to sympathetic nerve blockade-induced vasodilation.

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Key information

Conditions

Regional Anaesthsia Brachial Plexus Blocks

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Successful peripheral nerve blockade is fundamental to modern regional anesthesia, particularly for upper limb surgeries. Ensuring the efficacy of a nerve block early in the perioperative period is critical, as delayed recognition of block failure may lead to intraoperative pain, the need for additional sedation or general anesthesia, and overall poorer patient outcomes. Conventional methods for assessing block success, such as sensory testing with pinprick or cold stimuli and motor assessment using strength scales, require patient cooperation and often take 15-30 minutes to yield definitive results. These delays are especially limiting in fast-paced surgical environments or when early decisions regarding anesthesia management are necessary.

Emerging non-invasive monitoring technologies offer promising alternatives for early, objective assessment of block efficacy. Infrared Thermography (IRT) measures skin surface temperature, which increases with sympathetic nerve blockade-induced vasodilation. Perfusion Index (PI), derived from pulse oximetry, reflects peripheral perfusion and also rises as vascular tone decreases following a successful nerve block. Both IRT and PI provide quantifiable, real-time physiological markers of sympathetic and circulatory changes that precede full sensory or motor blockade. Although several studies support their individual utility, there is limited evidence on their combined predictive value or their integration into routine clinical practice. Further investigation is needed to validate their role in enhancing the accuracy and timeliness of block assessment.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Adults aged 18-70 years
  • ASA Physical Status I-III

Exclusion criteria

  • General
  • Coagulopathy
  • Allergy to local anesthetics
  • Special
  • Neurological deficits in the affected limb
  • Peripheral vascular disease or Raynaud's phenomenon
  • Infections or skin lesions at the site of injection
  • Use of a tourniquet

Treatment and study plan

Ultrasound-Guided Supraclavicular Block

Procedure

Ultrasound-guided supraclavicular brachial plexus block using a high-frequency linear ultrasound probe-real-time visualization of the brachial plexus for precise anesthetic delivery.

Bupivacaine Hydrochloride 0.5 % Injectable Solution

Drug

30 mL used for supraclavicular brachial plexus block

Ultrasound

Device

Imaging for block placement

Infrared Thermography Camera

Device

Skin temperature monitoring

Pulse Oximeter

Device

Perfusion Index monitoring

Primary outcomes

  1. Change in Skin Temperature (°C) Measured by Infrared Thermography From Baseline to 10 Minutes Post-block.

    Time frame: Baseline, 5, and 10 minutes post-injection

    Mean change in skin temperature on the operative limb captured using infrared thermography at defined time points.

  2. Change in Perfusion Index From Baseline to 10 Minutes Post-block

    Time frame: Baseline, 5, and 10 minutes post-injection

    PI measured via pulse oximeter; change calculated as ratio to baseline values.

Secondary outcomes

  1. Correlation Between Changes in Skin Temperature and Perfusion Index With Sensory and Motor Block Scores at 20 Minutes

    Time frame: 20 minutes post-injection

    Correlation between physiologic changes and clinical assessments of sensory and motor block success using pinprick/cold test and Modified Bromage Scale.

Study contacts

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

Tarek Ashraf Ibrahim Abd Al-Hafiz, resident doctor

CONTACT

[email protected]

+201092002284

Sponsors and collaborators

Lead sponsor

Assiut University

Other

Registry information

Official study title

Early Detection of Supraclavicular Brachial Plexus Block Failure Using Infrared Thermography and Perfusion Index: Randomized Double-Blind Controlled Study

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 30, 2025
Registry last updated
Jul 30, 2025

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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