Postoperative Pain
Conditions
Brief summary
A revised ultrasound-guided approach to the lumbar plexus is investigated as for efficacy and safety in elderly trauma patients undergoing operations of the lower extremeties.
Detailed description
A modified ultrasound-guided Shamrock approach combined to nerve stimulation of the lumbar plexus is going to be investigated, in elderly trauma patients undergoing procedures of the lower extremities. The technique is going to be assessed as for its safety and its accuracy in localization of the plexus, by multiple measurements of the imaging time and needling time, In addition, efficacy and complications will be recorded and assessed during the immediate postoperative period.
Interventions
PROCEDURElumbar plexus block
Patients undergoing orthopedic procedures of the lower extremeties are going to be studied. A modified Shamrock approach of the lumbar plexus is going to be used for postoperative analgesia, using an ultrasound-guided technique combined to a nerve stimulatior. The technique is going to be assessed as for accuracy, and safety.
Sponsors
University of Athens
Attikon Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing orthopedic trauma operations of the lower extremeties * Age \>70 years old
Exclusion criteria
* Preexisting neuropathy of Lumbar plexus * Coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood work up ie platelets ≤ 100, International Normalized Ratio ≥ 1.4 or prothrombin time ≥ 50) * Allergy to local anaesthetics * Prior surgery at the lumbar region
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time required to localize the lumbar plexus | 10 minutes (from the begining of imaging procedure) (time in seconds to localize the plexus) | The time (in secondes) required of this modified Shamrock method to localize the lumbar plexus in the interpsoas compartment in elderly-trauma patients undergoing orthopedic procedures of the lower extremeties. Imaging time will be calculated (time to obtain appropriate imaging of the plexus) as well as needling time (time to obtain appropriate needle placement on the plexus) |
| Complications from lumbar plexus blockade | 1 month | Safety of the modified Shamrock method of lumbar plexus blockade in elderly-trauma patients undergoing orthopedic procedures of the lower extremeties. All possible complications will be recorded (i.e. neurological complications, numbness, mobility disorder, haemmorhage, haematoma, e.t.c.) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain | 4 hours (visual analogue scale 0-10 at 4 hours postoperatively) | Postoperative pain relief 4 hours after completion of the block (visual analogue scale 0-10). A VAS score \<4 is considered adequate. |
Countries
Greece
Outcome results
None listed