Finding the Minimum Dose to Induce Sympathectomy in Infraclavicular
Conditions
Brief summary
For patients who undergoing hemodialysis, it is important to have good AV fistula. One third of AV fistula usually fail during early stage. It is helpful to use nerve block to dilate the blood vessels and enhance the prognosis. But 0.2% Ropivacaine usually cause muscle weakness in present studies. The investigators hope to find the lowest concentration to provide sympathectomy without muscle weakness. Because the patients with hemodialysis usually have multiple co-morbidity, thus we choose patients with forearm fracture at the first place. With this result, the investigators can design further study for patients with hemodialysis. The investigators prefer proximal approach because brachial plexus run together in the cosctoclavicular space and show lower incidence of incomplete work.
Interventions
Ultrasound-guided infraclavicular brachial plexus block
Sponsors
Taipei Medical University WanFang Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age between 20-80 y/o, BW: 40-90 kilograms，ASA class I-III，No pre-existing neuropathy，Scheduled for upper limb surgery.
Exclusion criteria
1. Pre-existing neuropathy (ex: polyneuropathy) 2. History of allergy to xylocaine、ropivacaine、epinephrine 3. Emergent surgery 4. Coagulopathy 5. Patient who can not express themselves
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of diameter of basilic vein and brachial artery | Change from baseline diameter(pre-nerve block) at 45min | Use ultrasound to measure the difference of diameter at different time point. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensory block of upper limb | 45min post nerve block | A validated 3-point scale was used: 0 = no block (patient has normal sensation), 1 = patient can feel cold, but the sensation is reduced compared with the unblocked side, and 2 = complete anesthesia. |
| Motor block of upper limb | 45min post nerve block | A validated 3-point scale was used: 0 = no block (patient has normal power), 1 = patient can feel weakness with the unblocked side, and 2 = complete anesthesia. |
Outcome results
None listed