Ultrasound-guided supraclavicular block versus Bier block for closed reduction of upper extremity injuries in the emergency department: an open-label, non-inferiority, randomised control trial
Grant ID: EMEG-030R38-2022-TSAO
Project Summary
Upper limb injuries including bony fractures/dislocations, are sometimes deformed and require realignment in the emergency department (ED). Numerous techniques are available to allow this procedure to be painless. Bier block (BB) involves placing a band on the upper part of the affected arm to constrict blood flow, with injection of numbing agent into a hand vein on the same side to make the entire arm numb. An alternative technique is ultrasound guided supraclavicular blocks (UGSCB), which involves introducing a needle under ultrasound guidance to nerves situated just above the collar bone and injecting numbing agent around these nerves to make the arm go numb. However, the effectiveness of UGSCB when performed by ED doctors is unknown and patients might recover more quickly. We aim to conduct a randomised trial to compare UGSCB versus BB for re-aligning fractures/dislocations of the upper limb in the ED.
Dissemination
Publication:
- Jones, P., Tsao, H. and Snelling, P., 2024. Ultrasound-guided supraclavicular block versus Bier block for emergency reduction of upper limb injuries: statistical analysis plan. Trials, 25(1), p.537.
- Tsao, H., Tang, C., Trembath, M., Jones, P., Snelling, P. J., 2023. Ultrasound-guided supraclavicular block versus Bier block for emergency reduction of upper limb injuries: a protocol for an open-label, non-inferiority, randomised controlled trial. Trials, 24(1), 1-10.
Presentations:
- Tsao, H., Tang, C., Cureton, A., Maskell, L., Trembath, M., Jones, P., Snelling, P.J., SUPraclavicular block for Emergency Reduction of upper limb injuries vs Bier block (SUPERB) trial. ACEM ASM 2024, Adelaide, Australia 24-28 November 2024.
Tsao, H., Tang, C., Cureton, A., Maskell, L., Farrel, R., Trembath, M., Jones, P., Snelling, P.J., Ultrasound-guided supraclavicular block using a two-injection technique is associated with ipsilateral phrenic nerve paresis (poster). ACEM ASM 2024, Adelaide, Australia 24-28 November 2024.
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