Nerve Block
Conditions
Brief summary
This study aims to better understand the dispersion of local anesthetic on the Erector Spinae Block, a new technique developed for analgesia. It consists on injection of local anesthetic around the posterior muscles of the Spine. In this study, the investigators will make the injection with coloring solution on cadavers and by dissection will note the dispersion of the solution according to injectate volume. The investigators hypothesize more volume allows bigger spread and will allow new indications of this technique in perioperative analgesia and treatment of chronic Pain
Detailed description
The study's methodology will include performing ultrasound guided erector spinae block in cadavers included in the study according to eligibility criteria. After signing of written consent form, the participants will be randomized on the height of the block (vertebral level - T3, T12 and L4) and the volume to be injected (10, 20 and 30ml). The block will be performed by experienced physicians on the technique by ultrasound guidance and fixed pressure measured with an in-line pressure monitor (15 psi) with the cadaver in the lateral position. The cadavers will be submitted to autopsy by standard thoracoabdominal midline incision, with the viscera removed for analysis. The cadavers will have their paraspinal muscles removed (quadratus lumborum and psoas major), the medial parietal pleura opened and the number of levels with colored solution registered, noting the spread to ventral rami of spinal nerves and to the paravertebral space.
Interventions
PROCEDUREErector Spinae Plane Block
Ultrasound guided injection of coloring solution (methylene blue diluted in water) with a 18G echogenic tuohy needle deep to the plane of the erector spinae muscles.
Sponsors
Irmandade da Santa Casa de Misericordia de Sao Paulo
Federal University of São Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
The cadavers will be randomized to receive the intervention (Erector Spinae Plane Block) on different levels (Vertebral level - T3, T12 and L4) and different volumes (10, 20 and 30ml)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Fresh Cadavers (not subject to formaldehyde fixation process or frozen \> 24h) * Age \> 18 years * Written informed consent signed by responsible party * Height \> 150cm and \< 190cm
Exclusion criteria
* Previous spinal surgery * Severe spinal deformity * BMI \> 35 kg/m2 * Absence of a responsible party to sign the written informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Spread of Coloring Solution secondary to volume injected and vertebral level of injection | 3 hours | Observation of coloring solution around the spinal nerves as they exit the vertebral foramen. Comparison of number of spinal nerves colored according to the volume injected and injection site. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spread of coloring solution to paravertebral space | 3 hours | Observation of coloring solution on the paravertebral space. Comparison of number of levels of the paravertebral space colored according to volume injected and injection site. |
Countries
Brazil
Contacts
Primary ContactMarcelo V Perez, PhD
Outcome results
None listed