A comparison of ultrasound and nerve stimulation for femoral catheter placement

Nerve stimulation in ultrasound guided femoral catheter placement. A comparison of two endpoints for correct needle tip position.

Status

Completed

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12608000376347

Enrollment

Registered

2008-07-31

Start date

2008-03-31

Completion date

2008-12-18

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

To compare two techniques for femoral nerve catheter placement: Ultrasound only and ultrasound combined with nerve stimulation. To compare the effect of these two placement methods on catheter placement time and the indices of catheter effectiveness. Secondary outcome measures will include degree of patient discomfort during insertion and number of needle passes needed for catheter insertion. The use of fluid spread as an end point for correct needle tip position would result in more efficient femoral nerve catheter placement while providing a catheter success rate comparable to that based on a neurostimulatory endpoint. If the primary hypothesis is confirmed, this study will provide evidence supporting the use of ultrasound only (without nerve stimulation) as an end point for interscalene catheter placement. At present the community standard is nerve stimulation. This may result in future patients undergoing catheter insertions with reduced needle passes. Potential benefits might include more efficient catheter placements, with less discomfort and with possibly a reduced incidence of short term neurological sequelae.

Interventions

Femoral nerve catheter placed using either ultrasound or nerve stimulation, needle endpoint. Ultrasound placement Needle will be placed just posterior to the femoral nerve using ultrasound imaging then catheter threaded 3 cm past needle tip. Nerve stimulation placement Needle will be placed such that a patella response is present at <0.5 mA. Catheter is then threaded 3 cm beyond needle tip. The duration of each procedure is 15 minutes, and the period of overall intervention is 48 hours.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Blinded (masking used)

Eligibility

Sex/Gender

All

Age

0 to No maximum

Healthy volunteers

Yes

Inclusion criteria

Patients requiring continuous femoral analgesia following elective knee surgery under the care of the principal investigator

Exclusion criteria

1. Patient refusal/inability to consent 2. Allergy amide LA drugs 3. Existing neurological disorders/neuropathy of the operative extremity 4. Infection at site of needle puncture 5. Ischaemic heart disease 6. Chronic opioid therapy

Outcome results