Health Condition 1: I739- Peripheral vascular disease, unspecified
Conditions
Interventions
Intervention1: CAPS block with femoral nerve block: Ultrasound guided CAPS (Cross-wise Approach to Popliteal Sciatic) block combined with femoral nerve block for anaesthesia in high risk patients unde
Sponsors
Dr Anandakumar
Eligibility
Inclusion criteria
Inclusion criteria: Patients aged 18 years and above ASA physical status III and IV Patients undergoing below knee amputation or below knee debridement Eligible to receive either CAPS block with femoral nerve block or femoral popliteal block Patients willing to provide written informed consent
Exclusion criteria
Exclusion criteria: Refusal to give informed consent Infection at the block injection site Allergy to local anaesthetics or study drugs Coagulopathy or patients on therapeutic anticoagulation as per institutional guidelines Severe local oedema or anatomical distortion preventing ultrasound visualization Pre existing major neuropathy in the affected limb Haemodynamic instability where regional block is unsafe Severe sepsis or septic shock requiring vasopressor support Inability to lie supine for block administration Mental status changes or inability to cooperate for block assessment Patients requiring immediate surgery not allowing time for block assessment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Block success rate:successful completion of below knee surgery without conversion to general anaesthesia. no need of additional block. no significant intraoperative rescue analgesiaTimepoint: assessed during the intraoperative period until completion of surgery | — |
Secondary
| Measure | Time frame |
|---|---|
| time for onset of block:Time taken to adequate sensory blockTimepoint: assessed every 5 minutes after block administration until adequate sensory block is achieved;duration of analgesia(time until first request for pain relief)Timepoint: up to 48 hours postoperatievly;Intraoperative haemodynamic stability(heart rate and blood pressure changes)Timepoint: throughout the interoperative period;Postoperative pain score(VAS score)Timepoint: 0 hour,2 hours,24 hours,48 hours postoperatievly;total rescue analgesia requirementTimepoint: with in first 24 hours postoperatievly;complications(hypotension,local anaesthetic toxicity,block failure,nerve injury)Timepoint: Intraoperative period and up to day 7 follow up | — |
Countries
India
Contacts
Public ContactANANDAKUMAR N
Institute of Anaesthesiology
Outcome results
None listed