Paracoracoid versus Costoclavicular Approach to Infraclavicular Block: A Prospective, Two Arm, Parallel design, Single-centre Randomized Controlled Trial
Bibliographic record
Abstract
ABSTRACT Introduction Paracoracoid approach to the brachial plexus block is the conventional infraclavicular technique for upper limb surgeries. In this approach, the ultrasound transducer is placed in the parasagittal plane below the clavicle, medial to the coracoid process. In this view, three cords are separated from each other and are rarely visualized in a single ultrasound window. In the costoclavicular approach, the ultrasound transducer is placed parallel to and below the clavicle. In this view, the cords are clustered together, at a more superficial level. We conducted a randomized controlled trial to compare these two infraclavicular brachial plexus approaches. Methods Seventy patients were randomized to receive either a paracoracoid or costoclavicular infraclavicular block. Both groups received 35 ml of 0.5% ropivacaine under ultrasound guidance. The primary outcome was sensory block onset time while secondary outcomes included performance times, complications during block insertion (paresthesia, vascular puncture, pleural puncture), block failure, patient satisfaction, and postoperative complications. Telephone follow-up was done 24 h and 7 days later. Results Sensory block onset time was significantly shorter in the paracoracoid group 18.7 (4.4) min versus 22.2 (6.2) min (p=0.045). Block success at 30 minutes was the same between both groups. There was no difference in any secondary outcomes. Conclusions This randomized controlled trial demonstrated that the novel costoclavicular approach to the infraclavicular brachial plexus block had similar procedure time, block success and similar complication rates for upper limb surgery when compared to the traditional paracoracoid technique. However, it resulted in longer sensory block onset time.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".