Anesthesia, Anesthesia; Adverse Effect, Anesthesia, Local
Conditions
Brief summary
Regional anaesthesia is a frequently used procedure. Currently, blockades are increasingly carried out without nerve stimulation. The risk of nerve lesion is about 3 %. Industrial efforts frequently referred to ultrasound optimisation of the regional anaesthesia cannula. In order to optimise patient safety, the benefit of both procedures (stimulation and ultrasound) should be combined and both procedures optimised. In this study, the influence of the needle electrode size on the stimulability of the nerve ischiadicus should be determined.
Detailed description
There are various methods of performing regional anesthesia. In recent years, the focus has been on ultrasound-supported regional anaesthesia, and the stimulation methods that were often used in the past were no longer used or used less frequently. The combination of both methods may be an additional safety aspect and can contribute to an improved blocking quality. In addition to the best possible ultrasound quality, an optimal stimulation quality is also required. The investigators plan to carry out dual-guidance blockages of the ischiadic nerve with various regional anaesthesia needles (manufacturer of the used needles: Pajunk Medical Produkte GmbH, Geisingen, Germany; Teleflex Medical GmbH, Kernen, Germany). All regional anaesthesia cannulae are approved for the planned blockades of humans in Germany.
Interventions
PROCEDURERegional Anesthesia Touhy
The patients receive the planned anaesthesia procedure according to the procedure to be performed. Only nerve blockages are carried out, which are considered to be analgesic useful for the planned operations on the basis of typical nerve courses. A touhy cannula is used.
PROCEDURERegional Anesthesia Facet
The patients receive the planned anaesthesia procedure according to the procedure to be performed. Only nerve blockages are carried out, which are considered to be analgesic useful for the planned operations on the basis of typical nerve courses. A facet cannula is used.
Sponsors
Charite University, Berlin, Germany
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
The selection of the puncture cannula for regional anaesthesia is not up to the performing anaesthetist, as is usual in the clinical standard, but is made randomly on the basis of a random list. The blockade is carried out by two anaesthetists experienced in regional anaesthesia, who have the principle of dual control. The ultrasound image acquired during the blockade is recorded in the form of an ultrasound video for subsequent evaluation. The recorded ultrasound videos are stored pseudonymously on the server of the Klinik für Anästhesiologie m. S. operativ Intensivmedizin reported to the data protection department.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Presence of the written declaration of consent * Age of at least 18 years * No participation in another intervention study during participation
Exclusion criteria
* present contraindication for the application of regional anesthesia and nerve stimulation * Cardiac pacemaker/AICD (Automated internal cardioverter defibrillator) carrier * Known allergies to used medicines * Patients under 18 years of age * Ineligible patients * Missing consent * Pregnancy/nursing patients * Classification of patients into class 4 or higher status according to the American Society of Anesthesiologists * Existing nerve damage in the target area * Medically treated diabetes mellitus, alcohol abuse or alcohol abuse in the patient's history (using AUDIT) * Visibility score of the nerve of 3 or more * Participation in another intervention study during participation * Accommodation in an institution on the basis of a court or administrative order
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasound distance | duration of blockade, an average of 15 minutes | Ultrasound-based measurement of needle-nerve distance during the application of the regional anesthesia of the N. ischiadicus during infragluteal access. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visibility_2 | duration of blockade, an average of 15 minutes | Ultrasound visibility of nerve |
| Impedance | duration of blockade, an average of 15 minutes | Impedance measured by nerve stimulator while progressing the needle |
| Effect_motor | duration of surgery and recovery unit, an average of 120 minutes | Effectiveness of the motor blockade measured by possible movement of the foot |
| Effect_sensoric | duration of surgery and recovery unit, an average of 120 minutes | Effectiveness of the blockade measured by temperature sensibility testing on the food |
| Visibility_1 | duration of blockade, an average of 15 minutes | Ultrasound visibility of needle |
Other
| Measure | Time frame | Description |
|---|---|---|
| Contact | duration of blockade, an average of 15 minutes | Number of Needle-Nerve-Contacts by Ultrasound-measurement |
| Complications | duration of surgery and recovery unit, an average of 120 minutes | Occurence of complications of regional anesthesia |
| Impedance_Change | duration of blockade, an average of 15 minutes | Changes in impedance measurement while blockade |
Countries
Germany
Outcome results
None listed