Nerve Block
Conditions
Keywords
Regional anesthesia, Ultrasound guided brachial plexus blockade, Local anesthetics : Ropivacaine
Brief summary
Assessement of a new approach of an ultrasound guided brachial plexus blockade between the infraclavicular and axillary area.
Detailed description
After an assessement of this new approach of ultrasounded-guided brachial plexus blockade in cadavers, the aim of this human study was to asssess the validity of this method in humans. The probe will be disposed on the shoulder, and the brachial plexus will be seeked below the deltoid, lateral to the major pectoralis muscle and in the vicinity of the brachial artery. At this area, an ultrasounded guided needle was inserted with an in-plane direction towards the brachial artery and local anesthetics was disposed all around the artery, without puncturing the differents nerves. Regional blockade will be evaluated by measuring onset and duation time for sensitive and motor blockade, effectiveness of this blockade, patient's confort during the procedure, ease of the procedure for practitionner, quality of ultrasound image's interpretation before and after injection.
Interventions
PROCEDUREUltrasound guided brachial plexus blockade
Ultrasound probe disposed on the shoulder, on the deltoid muscle. in plane puncture toward the brachial artery and injection of local anaesthetics around the brachial artery
Local anesthetic injection (ropivacaine) at this new site
Sponsors
University of Liege
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Descriptive study
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Arm surgery performed under axillary blockade
Exclusion criteria
* Local anesthetics allergy * Coagulation disorder * History of chronic pain * Drug or alcohol abuse
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of sensitive block for the musculocutaneous nerve at 20 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 20 minutes post injection | Evaluation of sensitive block for the musculocutaneous nerve at 20 minutes post injection |
| Evaluation of motor block for the musculocutaneous nerve at 20 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 20 minutes post injection | Evaluation of motor block for the musculocutaneous nerve |
| Evaluation of sensitive block for the median nerve at 5 minutes post injection assessed by a scale of sensitive function (0 = No sensibility, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 5 minutes post injection | Evaluation of sensitive block for the median nerve at 5 minutes post injection |
| Evaluation of sensitive block for the median nerve at 10 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 10 minutes post injection | Evaluation of sensitive block for the median nerve at 10 minutes post injection |
| Evaluation of sensitive block for the median nerve at 15 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 15 minutes post injection | Evaluation of sensitive block for the median nerve at 15 minutes post injection |
| Evaluation of sensitive block for the median nerve at 20 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 20 minutes post injection | Evaluation of sensitive block for the median nerve at 20 minutes post injection |
| Evaluation of sensitive block for the ulnar nerve at 5 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 5 minutes post injection | Evaluation of sensitive block for the ulnar nerve at 5 minutes post injection |
| Evaluation of sensitive block for the ulnar nerve at 10 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 10 minutes post injection | Evaluation of sensitive block for the ulnar nerve at 10 minutes post injection |
| Evaluation of sensitive block for the ulnar nerve at 15 minutes post injection (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 15 minutes post injection | Evaluation of sensitive block for the ulnar nerve at 15 minutes post injection |
| Evaluation of sensitive block for the ulnar nerve at 20 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 20 minutes post injection | Evaluation of sensitive block for the ulnar nerve at 20 minutes post injection |
| Evaluation of sensitive block for the radial nerve at 5 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 5 minutes post injection | Evaluation of sensitive block for the radial nerve at 5 minutes post injection |
| Evaluation of sensitive block for the ulnar nerve at 15 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 15 minutes post injection | Evaluation of sensitive block for the ulnar nerve at 15 minutes post injection |
| Evaluation of sensitive block for the musculocutaneous nerve at 5 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 5 minutes post injection | valuation of sensitive block for the musculocutaneous nerve at 5 minutes post injection |
| Evaluation of sensitive block for the musculocutaneous nerve at 10 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 10 minutes post injection | Evaluation of sensitive block for the musculocutaneous nerve at 10 minutes post injection |
| Evaluation of sensitive block for the musculocutaneous nerve at 15 minutes post injection assessed by a scale of sensitive function (0 = No sensibilityto cold, 1 = partial insensibility to cold, 2 = Normal sensation to cold) | 15 minutes post injection | Evaluation of sensitive block for the musculocutaneous nerve at 15 minutes post injection |
| Feasibility of block realisation assessed by number of abandonned block | Immediately after procedure | Difficulty in the block realisation (block abandonned before or during realisation) |
| Efficience of the block assessed by number of block sufficient for surgery | Immediately after procedure | Is the block enough for surgery or must be completed |
| Comfort during block realization assessed by Numeric Rating Scale (NRS - 0 = No pain, 10 = worse pain) | Immediately after procedure | Evaluation of comfort during block realization |
| Evaluation of motor block for the median nerve at 5 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 5 minutes post injection | Evaluation of motor block for the median nerve |
| Evaluation of motor block for the median nerve at 10 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 10 minutes post injection | Evaluation of motor block for the median nerve |
| Evaluation of motor block for the median nerve at 15 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 15 minutes post injection | Evaluation of motor block for the median nerve |
| Evaluation of motor block for the median nerve at 20 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 20 minutes post injection | Evaluation of motor block for the median nerve |
| Evaluation of motor block for the ulnar nerve at 5 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 5 minutes post injection | Evaluation of motor block for the ulnar nerve |
| Evaluation of motor block for the ulnar nerve at 10 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 10 minutes post injection | Evaluation of motor block for the ulnar nerve |
| Evaluation of motor block for the ulnar nerve at 15 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 15 minutes post injection | Evaluation of motor block for the ulnar nerve |
| Evaluation of motor block for the ulnar nerve at 20 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 20 minutes post injection | Evaluation of motor block for the ulnar nerve |
| Evaluation of motor block for the radial nerve at 5 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 5 minutes post injection | Evaluation of motor block for the radial nerve |
| Evaluation of motor block for the radial nerve at 10 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 10 minutes post injection | Evaluation of motor block for the radial nerve |
| Evaluation of motor block for the radial nerve at 15 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 15 minutes post injection | Evaluation of motor block for the radial nerve |
| Evaluation of motor block for the radial nerve at 20 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 20 minutes post injection | Evaluation of motor block for the radial nerve |
| Evaluation of motor block for the musculocutaneous nerve at 5 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 5 minutes post injection | Evaluation of motor block for the musculocutaneous nerve |
| Evaluation of motor block for the musculocutaneous nerve at 10 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 10 minutes post injection | Evaluation of motor block for the musculocutaneous nerve |
| Evaluation of motor block for the musculocutaneous nerve at 15 minutes post injection assessed by a scale of motor function (0 = Complete paresis, 1 = Partial paresis, 2 = Normal motion) | 15 minutes post injection | Evaluation of motor block for the musculocutaneous nerve |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Demographic data WEIGHT | At the time of the procedure | Weight of the patient |
| Demographic data HEIGHT | At the time of the procedure | Height of the patient |
| Type of surgery | At the time of the procedure | hand surgery on bone/tendon/ligament/skin/nerve |
| Tourniquet | At the time of the procedure | Time of tourniquet during surgery |
| Type of hospitalization | At the time of the procedure | One or more day hospitalization |
| Local anesthetics used | At the time of the procedure | Amount of local anesthetics used |
| Operator impression | At the time of the procedure | Impression of the difficulty for the operator to perform the block |
| Incident during block performance | At the time of the procedure | Incidence during block performance |
| Duration of block performance | At the time of the procedure | Time of block performance |
| Duration of motor block | from 0 to day 1 | duration of motor block |
| Duration of sensitive block | from 0 to day 1 | duration of sensitive block |
| Block injury | From day 0 to day 7 | Neuropathy or other secondary effect post block during 7 days |
| Comparative image axillary and novel point of puncture | During the procedure | Number of halo separating artery from different nerves at this novel level and at the axillary level |
| Demographic data AGE | At the time of the procedure | Age of the patient |
Countries
Belgium
Contacts
Primary ContactJean-Pierre H Lecoq, MD, PhD
Outcome results
None listed