None listed
Conditions
Brief summary
The purpose of this current study is to compare the 'in-plane' with 'out-of-plane' methods of ultrasound guided interscalene brachial plexus catheter placement for analgesia in patients having elective shoulder surgery. We plan to assess the effectiveness of analgesia, side effects and patient satisfaction. There is controversy surrounding the best approach for placing these catheters, hence the reasons for doing the study.
Interventions
Posterior Group
The needle will be inserted at a point posteriorly and advanced anteriorly in the plane of the ultrasound (US) beam until the needle tip is visualised just lateral to the 2 most superficial elements of the brachial plexus.
In both groups, dextrose 5% 5-10 mL will be injected down the needle to observe for appropriate fluid spread adjacent to the brachial plexus trunks, and a non-stimulating catheter advanced 1-2 cm past the needle tip. If US imaging proves difficult, a brief appr
Posterior Group The needle will be inserted at a point posteriorly and advanced anteriorly in the plane of the ultrasound (US) beam until the needle tip is visualised just lateral to the 2 most superficial elements of the brachial plexus. In both groups, dextrose 5% 5-10 mL will be injected down the needle to observe for appropriate fluid spread adjacent to the brachial plexus trunks, and a non-stimulating catheter advanced 1-2 cm past the needle tip. If US imaging proves difficult, a brief appropriate muscle twitch will be sought with a nerve stimulator set to 0.8 mA to confirm brachial plexus position.
Sponsors
Dr Michael Fredrickson
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 interscalene analgesia following elective shoulder surgery under the care of the Principal Investigator.
Exclusion criteria
1. Patient refusal for interscalene block. 2. Severe respiratory disease or ischaemic heart disease. 3. Known neuropathy involving the arm undergoing surgery. 4. Known allergy to amide local anaesthetic drugs. 5. Chronic opioid therapy. 6. Infection at site of needle puncture.
Outcome results
None listed