Chronic Lower Limb Ischemia
Conditions
Brief summary
The fascia iliaca block (FIB) is an anterior approach to block the lumbar plexus. It disturbed mainly to the anterior region of the thigh by blocking the femoral nerve (LFC) and the lateral femoral cutaneous nerve. Moreover, FIB may possibly be extended to the obturator, ilioinguinal, genitofemoral, lateral cutaneous nerve of the thigh and over the psoas muscle but, rarely reaches the lumbar plexus. The fascia iliaca compartment could be detected by bony landmarks palpation and the loss of resistance technique. Feeling two tactile ''pops'' due to loss of resistance occurred during the needle passage through the fascia lata and the fascia iliaca. Ultrasound (US) guidance of FIB will increase the success rate and the efficacy of sensory blockade by decreasing the needed local anesthetic amount.
Detailed description
This study was conducted to demonstrate the success incidence (to evaluate the efficacy) of preoperative 0.25% bupivacaine FIB as a sole anesthetic technique in thromboembolectomy of unilateral chronic lower limb ischemia compared to neuraxial anesthesiaas a primary goal. Intraoperative hemodynamics variation, postoperative pain score, total analgesic rescue requests and the total amount of systemic rescue analgesia used in the first postoperative day in addition to any detected postoperative complications were secondary goals. The hypothesis is that; FIB will provide adequate anesthesia as neuraxial anesthesia.
Interventions
ultrasound-guided Fascia iliaca block
OTHERSpinal anesthesia
Spinal anaesthesia using 2 ml hyperbaric bupivacaine 0.5%
Sponsors
Mansoura University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* ASA physical status I or II.
Exclusion criteria
* Patients with previous same lower limb surgery * Neuromuscular disease * Severe cardiovascular disease * Any contraindications to regional anesthesia * patient refusal * coagulation abnormality * Known allergy to local anesthetics * Infection at the injection site
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of the patients who did not require conversion to general anesthesia | for 30 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | For 6 hours after the intervention | changes in Heart rate |
| mean arterial pressure (MAP | For 6 hours after the intervention | changes in mean arterial pressure (MAP |
| Postoperative pain | For 24 hours after the intervention | The post-operative pain will recorded using 10-point Visual Analog Scale (VAS) |
| Any observed adverse effects | over the 24 hours postoperative | ny adverse effects will be observed over the 24 hours postoperative for local skin hematoma ,sensory deficits or local bleeding |
| bradycardia | For 24 hours from the block | Incidents if bradycardia |
| hypotension | For 24 hours from the block | Incidents of hypotension |
Countries
Egypt
Outcome results
None listed