Peripheral Nerve Injury
Conditions
Keywords
Ultrasound guidance, Femoral nerve block, Needle placement, Intraneural needle insertion
Brief summary
Ultrasound-guided femoral nerve block is a common regional anesthesia technique. The optimal method of needle guidance (in-plane versus out-of-plane) with regards to the block efficacy and avoidance of needle-nerve contact has not been established. In this study the investigators tests the hypothesis that the incidence of needle-nerve contact is higher with the needle insertion in an out-of-plane than with the in-plane approach.
Detailed description
Fourty-four patients with hip fracture (American Society of Anesthesiologists physical status 1-3) are being randomized to receive the femoral block with an out-of-plane (needle inserted at a 45°-60° angle 1 cm caudal to the midpoint of the ultrasound probe just above the femoral nerve) or an in-plane technique (needle inserted 0.5 cm from the side of the probe lateral to the femoral nerve). The data collected includes the depth of needle insertion at the endpoint before injection, response to nerve stimulation, distribution of the injected volume in relation to the nerve (anterior vs posterior, the latter indicating impalement), block efficacy at 20 minutes and 24 hours, and any signs of nerve injury).
Interventions
PROCEDURENeedle placement
In plane versus out of plane needle placement techniques
Sponsors
Hospital Clinic of Barcelona
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA physical status 1-3 patients * Diagnosis of trochanteric or cervical hip fracture * Hip replacement under spinal anesthesia
Exclusion criteria
* Patients under the age of 65 years or over the age of 90 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of intraneural needle insertion in ultrasound-guided femoral block: out-of-plane versus in-plane approach | 4 months | The incidence of needle-nerve contact is higher with the out-of-plane approach (inserting the needle into the fascia at the midpoint over the femoral nerve)needle-nerve contact than with the in-plane approach (inserting the needle lateral to the femoral nerve). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with femoral block success in ultrasound-guided femoral block: out-of-plane versus in-plane approach. | 4 months | The efficacy of the out-of-plane approach (inserting the needle into the fascia at the midpoint over the femoral nerve)needle-nerve contact and the in-plane approach (inserting the needle lateral to the femoral nerve). |
Countries
Spain, United States
Contacts
Primary ContactAna Ruiz, MD
Backup ContactXavier Sala-Blanch, MD
Outcome results
None listed