Forearm FracturesNCT07418086
Supraclavicular Block vs Bier's Block for Forearm Trauma Surgery
A study testing Bier's Block (IVRA) and Supraclavicular Block in people with Forearm Fractures, run by Sargodha Medical College at 1 site in Pakistan.
Trial summary
This study compared two common anesthesia techniques used for forearm trauma surgery-Bier's block and the supraclavicular block-to determine which provides better surgical conditions and patient comfort. Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Forearm Fractures
- What is being tested?
- Bier's Block (IVRA) and Supraclavicular Block
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 66 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Apr 2023to 1 Feb 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adults aged 18 to 60 years
- ASA physical status I-III
- Patients scheduled for elective or emergency forearm surgery
- Presence of forearm fracture or upper limb trauma requiring regional anesthesia
- Ability to provide informed consent
Who cannot join
- Patient refusal or inability to give informed consent
- Known allergy to local anesthetic agents
- Coagulopathy or bleeding disorders
- Infection at the block site
- Pre-existing neurological deficits in the affected limb
- Severe cardiac, hepatic, or renal disease
Show all 10Show fewer
- History of seizure disorders
- Pregnancy
- ASA physical status IV or higher
- Inability to cooperate with block assessment
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparative Study of Supraclavicular Block and Bier's Block in Forearm Surgery in Trauma Patients
This study compared two common anesthesia techniques used for forearm trauma surgery-Bier's block and the supraclavicular block-to determine which provides better surgical conditions and patient comfort. Among the 66 patients studied, Bier's block produced a much faster onset of numbness and muscle relaxation, but its pain relief wore off quickly. In contrast, the supraclavicular block took longer to take effect but provided significantly longer-lasting postoperative pain relief and greater overall patient comfort, making it more suitable for trauma cases where prolonged anesthesia and smoother recovery are needed. Overall, the study found the supraclavicular block to be the more effective and patient-friendly option for forearm surgeries.
Read the detailed description
Forearm trauma surgery commonly requires regional anesthesia to provide surgical conditions and postoperative pain relief. Two widely used techniques are Bier's block (intravenous regional anesthesia) and the supraclavicular brachial plexus block, but limited evidence exists comparing their performance specifically in trauma patients. This randomized controlled trial evaluates these two approaches to determine differences in onset of sensory and motor block, duration of postoperative analgesia, and patient comfort. Bier's block is known for its simplicity and rapid onset but is limited by tourniquet pain and a short duration of analgesia once the tourniquet is released. In contrast, the supraclavicular block provides dense anesthesia of the upper limb with the potential for longer postoperative pain relief, especially when performed under ultrasound guidance. In this study, 66 adult patients undergoing forearm surgery were randomized to receive either Bier's block or supraclavicular block using standardized techniques. An independent observer assessed block onset and recovery characteristics, and patient comfort was recorded using validated scales. The goal of this study is to generate evidence that may guide anesthetic selection for forearm trauma cases by identifying which block technique offers better perioperative performance and enhances postoperative pain control while avoiding unnecessary duplication of data reported in other fields of the trial record.
- Conditions
- Forearm Fractures
- Being tested
- Bier's Block (IVRA), Supraclavicular Block
- Keywords
- Brachial Plexus Block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bier's Block (IVRA)Procedure or surgery
Participants received an intravenous regional anesthesia (Bier's block). After placement of an IV line in the distal operative limb, the limb was exsanguinated with an Esmarch bandage and a double-cuff tourniquet was applied. The proximal cuff was inflated 50-100 mmHg above systolic pressure, followed by injection of 30 mL of 0.5% lidocaine through the IV. The distal cuff was inflated after 20-30 minutes or if tourniquet discomfort occurred. This technique produced regional anesthesia for forearm surgery.
Supraclavicular BlockProcedure or surgery
Participants received an ultrasound-guided supraclavicular brachial plexus block. Premedication included midazolam (1 mg IV) and nalbuphine (0.1 mg/kg IV). A total of 30 mL local anesthetic was injected using a two-point needle technique under real-time ultrasound visualization. After block establishment, a single tourniquet was applied at 100 mmHg above systolic pressure for the surgical procedure.
| Study group | Role | What they receive |
|---|---|---|
| Bier's Block (IVRA) | Experimental | Participants assigned to this arm received a Bier's block (Intravenous Regional Anesthesia). After IV access was established distally in the operative limb, the limb was exsanguinated using an Esmarch bandage and a double pneumatic tourniquet was applied. The proximal cuff was inflated 50-100 mmHg above systolic pressure, followed by IV administration of 30 mL of 0.5% lidocaine. The distal cuff was inflated after 20-30 minutes or upon tourniquet discomfort. This technique provided regional anesthesia for forearm surgery. Receives: Procedure: Bier's Block (IVRA) |
| Supraclavicular Block | Experimental | Participants received an ultrasound-guided supraclavicular brachial plexus block. After premedication with midazolam (1 mg) and nalbuphine (0.1 mg/kg), a 30 mL local anesthetic dose was injected using a two-point needle technique under real-time ultrasound visualization. A single tourniquet was applied at 100 mmHg above systolic pressure after block establishment. This technique provided anesthesia for forearm trauma surgery. Receives: Procedure: Supraclavicular Block |
What is being measured
The primary outcome is the main question the study is designed to answer.
1)onset of sensory block 2)degree of motor blockade
ONSET OF SENSORY BLOCK It is the period of time between the local anesthesia injection and the loss of pinprick sensation.
0=feeling sharp pinprick (no block)
- blunt sensation on pinprick (partial block)
- no sensation on pinprick (complete block). DEGREE OF MOTOR BLOCKADE Motor blockade was assessed by modified Bromage scale 0 = normal muscle function with full range of movement of elbow, wrist and fingers 1 = decreased muscle power so that patient can move fingers and /or wrist only 2 = complete loss of muscle function with movement in fingers/wrist
Measured: 6 months
Secondary outcomes (1)
3)duration of analgesia
DURATION OF ANALGESIA It was calculated from the time of onset of loss of pinprick for the first time during post-operative period (next 24 hrs.). The Visual Analogue Scale was used to determine pain scores.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Feb 2026
- Study start1 Apr 2023
- Primary completion1 Jan 2024
- Study completion1 Feb 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Forearm FracturesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study used a parallel interventional design, in which participants were randomly allocated into two independent groups. Each group received a different intervention, and all participants remained in their assigned group for the entire duration of the study. Outcomes-including onset of sensory block, motor block, duration of analgesia, and patient comfort-were measured and compared between the two groups without crossover. Group B received Bier's block (IVRA) and Group S received Supraclavicular block, allowing a direct comparison of the effectiveness of both anesthesia techniques in forearm trauma surgery.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 66 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sargodha Medical College
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Abira Rashid, Sargodha Medical College
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07418086
- Sponsor's protocol ID
- SMC-ANS-2025-004
- Status last verified
- Feb 2026
- First submitted
- 1 Dec 2025
- Last updated
- 18 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Your study is a single-center anesthesia comparison trial. There is no requirement to share individual participant data (IPD). Unless you have a formal data-sharing mechanism (repository, request process, timelines), selecting Yes will create extra mandatory fields.
Publications
Dodds SD, et al. The utility of CT scans for distal radius fractures. J Hand Surg. 2008;33:954-957.
Small J, Brennwald J. Median nerve palsy associated with distal radius fracture. J Hand Surg. 1994;19:185-186.
Pidgeon TS, et al. The operative treatment of distal radial fractures: a review of evidence. J Hand Surg. 2010;35:654-660.
Houshian S, Torfing T, Borris LC. The epidemiology of elbow fractures in adults. J Shoulder Elbow Surg. 2001;10:43-47.
Lamblet Z, Derossis AM, Isler MH, Sanders DW. Isolated ulnar shaft fractures can be treated with closed reduction and cast immobilization: a retrospective review. J Bone Joint Surg Am. 2004;86-A:1901-1905.
Study at a glance
From the registry record, last updated by the sponsor on 18 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Study of Supraclavicular Block and Bier's Block in Forearm Surgery in Trauma Patients
- ClinicalTrials.gov ID
- NCT07418086
- Acronym / sponsor ID
- SMC-ANS-2025-004
- Conditions
- Forearm Fractures
- Keywords
- Brachial Plexus Block
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 66 participants (actual)
- Lead sponsor
- Sargodha Medical CollegeUniversity, hospital or other
- Study start
- 1 Apr 2023 (actual)
- Primary completion
- 1 Jan 2024 (actual)
- Study completion
- 1 Feb 2024 (actual)
- First posted
- 18 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study compared two common anesthesia techniques used for forearm trauma surgery-Bier's block and the supraclavicular block-to determine which provides better surgical conditions and patient comfort. Among the 66 patients studied, Bier's block produced a much faster onset of numbness and muscle relaxation, but its pain relief wore off quickly. In contrast, the supraclavicular block took longer to take effect but provided significantly longer-lasting postoperative pain relief and greater overall patient comfort, making it more suitable for trauma cases where prolonged anesthesia and smoother recovery are needed. Overall, the study found the supraclavicular block to be the more effective and patient-friendly option for forearm surgeries.
Detailed description
Forearm trauma surgery commonly requires regional anesthesia to provide surgical conditions and postoperative pain relief. Two widely used techniques are Bier's block (intravenous regional anesthesia) and the supraclavicular brachial plexus block, but limited evidence exists comparing their performance specifically in trauma patients. This randomized controlled trial evaluates these two approaches to determine differences in onset of sensory and motor block, duration of postoperative analgesia, and patient comfort. Bier's block is known for its simplicity and rapid onset but is limited by tourniquet pain and a short duration of analgesia once the tourniquet is released. In contrast, the supraclavicular block provides dense anesthesia of the upper limb with the potential for longer postoperative pain relief, especially when performed under ultrasound guidance. In this study, 66 adult patients undergoing forearm surgery were randomized to receive either Bier's block or supraclavicular block using standardized techniques. An independent observer assessed block onset and recovery characteristics, and patient comfort was recorded using validated scales. The goal of this study is to generate evidence that may guide anesthetic selection for forearm trauma cases by identifying which block technique offers better perioperative performance and enhances postoperative pain control while avoiding unnecessary duplication of data reported in other fields of the trial record.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- This study used a parallel interventional design, in which participants were randomly allocated into two independent groups. Each group received a different intervention, and all participants remained in their assigned group for the entire duration of the study. Outcomes-including onset of sensory block, motor block, duration of analgesia, and patient comfort-were measured and compared between the two groups without crossover. Group B received Bier's block (IVRA) and Group S received Supraclavicular block, allowing a direct comparison of the effectiveness of both anesthesia techniques in forearm trauma surgery.
| Arm | Type | Receives |
|---|---|---|
| Bier's Block (IVRA) | Experimental | Procedure: Bier's Block (IVRA)Participants assigned to this arm received a Bier's block (Intravenous Regional Anesthesia). After IV access was established distally in the operative limb, the limb was exsanguinated using an Esmarch bandage and a double pneumatic tourniquet was applied. The proximal cuff was inflated 50-100 mmHg above systolic pressure, followed by IV administration of 30 mL of 0.5% lidocaine. The distal cuff was inflated after 20-30 minutes or upon tourniquet discomfort. This technique provided regional anesthesia for forearm surgery. |
| Supraclavicular Block | Experimental | Procedure: Supraclavicular BlockParticipants received an ultrasound-guided supraclavicular brachial plexus block. After premedication with midazolam (1 mg) and nalbuphine (0.1 mg/kg), a 30 mL local anesthetic dose was injected using a two-point needle technique under real-time ultrasound visualization. A single tourniquet was applied at 100 mmHg above systolic pressure after block establishment. This technique provided anesthesia for forearm trauma surgery. |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Adults aged 18 to 60 years
- ASA physical status I-III
- Patients scheduled for elective or emergency forearm surgery
- Presence of forearm fracture or upper limb trauma requiring regional anesthesia
- Ability to provide informed consent
Key exclusion criteria (10 listed)
- Patient refusal or inability to give informed consent
- Known allergy to local anesthetic agents
- Coagulopathy or bleeding disorders
- Infection at the block site
- Pre-existing neurological deficits in the affected limb
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bier's Block (IVRA)Participants received an intravenous regional anesthesia (Bier's block). After placement of an IV line in the distal operative limb, the limb was exsanguinated with an Esmarch bandage and a double-cuff tourniquet was applied. The proximal cuff was inflated 50-100 mmHg above systolic pressure, followed by injection of 30 mL of 0.5% lidocaine through the IV. The distal cuff was inflated after 20-30 minutes or if tourniquet discomfort occurred. This technique produced regional anesthesia for forearm surgery. | Procedure or surgery | Bier's Block (IVRA) |
| Supraclavicular BlockParticipants received an ultrasound-guided supraclavicular brachial plexus block. Premedication included midazolam (1 mg IV) and nalbuphine (0.1 mg/kg IV). A total of 30 mL local anesthetic was injected using a two-point needle technique under real-time ultrasound visualization. After block establishment, a single tourniquet was applied at 100 mmHg above systolic pressure for the surgical procedure. | Procedure or surgery | Supraclavicular Block |
Primary outcome
1)onset of sensory block 2)degree of motor blockade
Time frame: 6 months
ONSET OF SENSORY BLOCK It is the period of time between the local anesthesia injection and the loss of pinprick sensation. 0=feeling sharp pinprick (no block) 1. blunt sensation on pinprick (partial block) 2. no sensation on pinprick (complete block). DEGREE OF MOTOR BLOCKADE Motor blockade was assessed by modified Bromage scale 0 = normal muscle function with full range of movement of elbow, wrist and fingers 1 = decreased muscle power so that patient can move fingers and /or wrist only 2 = complete loss of muscle function with movement in fingers/wrist
1 secondary outcome
3)duration of analgesia
Time frame: 6 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Feb 2026.
- BackgroundDodds SD, et al. The utility of CT scans for distal radius fractures. J Hand Surg. 2008;33:954-957.
- BackgroundSmall J, Brennwald J. Median nerve palsy associated with distal radius fracture. J Hand Surg. 1994;19:185-186.
- BackgroundPidgeon TS, et al. The operative treatment of distal radial fractures: a review of evidence. J Hand Surg. 2010;35:654-660.
- BackgroundHoushian S, Torfing T, Borris LC. The epidemiology of elbow fractures in adults. J Shoulder Elbow Surg. 2001;10:43-47.
- Results publicationLamblet Z, Derossis AM, Isler MH, Sanders DW. Isolated ulnar shaft fractures can be treated with closed reduction and cast immobilization: a retrospective review. J Bone Joint Surg Am. 2004;86-A:1901-1905.
- Individual participant dataSharing planned: No. Your study is a single-center anesthesia comparison trial. There is no requirement to share individual participant data (IPD). Unless you have a formal data-sharing mechanism (repository, request process, timelines), selecting Yes will create extra mandatory fields.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Bier's Block (IVRA) and Supraclavicular Block in people with Forearm Fractures, run by Sargodha Medical College at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
1)onset of sensory block 2)degree of motor blockade (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07418086, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Feb 2026.