Shoulder Surgery
Conditions
Keywords
cervical, paravertebral, block
Brief summary
Cervical paravertebral blocks (CPVBs) target the brachial plexus from a puncture site situated in the posterior aspect of the neck and represent an alternative to interscalene blocks (ISBs) for shoulder and proximal humeral surgery. Randomized controlled trials comparing CPVB and ISB have found no significant differences in success rate, onset and offset times. Because of the reliability of their cutaneous landmarks, CPVBs have become part of the investigators' standard practice. With this approach, the brachial approach can be identified either with loss of resistance to air (LOR) or nerve stimulation (NS). While some authors have used only LOR and reported good success rates, others have hypothesized that NS may increase the reliability of the block. In the proposed study, for the first time, the 2 methods will be formally compared.
Interventions
OTHERNerve stimulation
CPVB with NS
OTHERLoss of resistance to air
CPVB with LOR
Sponsors
McGill University Health Centre/Research Institute of the McGill University Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
are: * age between 18 and 70 years * American Society of Anesthesiologists classification 1-3 * body mass index between 20 and 28
Exclusion criteria
are: * adults who are unable to give their own consent * pre-existing obstructive or restrictive lung disease (assessed by history and physical examination) * pre-existing neuropathy (assessed by history and physical examination) * coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood work up ie platelets≤ 100, International Normalized Ratio≥ 1.4 or prothrombin time ≥ 50) * renal failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work up ie creatinine≥ 100) * hepatic failure (assessed by history and physical examination and, if deemed clinically necessary, by blood work up ie transaminases≥ 100) * allergy to local anesthetic agents (LA) * pregnancy * prior cervical spine surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success | 8 months |
Secondary
| Measure | Time frame |
|---|---|
| performance time, onset time, side effects | 8 months |
Countries
Canada
Contacts
Primary ContactDe QH Tran, MD, FRCPC
Backup ContactRoderick J Finlayson, MD, FRCPC
Outcome results
None listed