Disorder of Shoulder
Conditions
Brief summary
This study was designed to determine whether the success or failure of interscalene brachial plexus block under general anesthesia can be predicted using perfusion index (PI).
Detailed description
The success of peripheral nerve blocks is usually evaluated by assessment of sensory and motor function; however, this method cannot be applied in the patient who has uncheckable mental status, e.g. general anesthesia, or who is uncommunicable, e.g. different language user. The perfusion index (PI) is a numerical value for the ratio between pulsatile and non-pulsatile blood flow measured by a special pulse oximeter, and PI had been proved as a useful tool for evaluation of successful supraclavicular nerve block in awake patients as an objective method. With the use of ultrasound guidance in skilled hands, it is a reasonable option to perform neuraxial and peripheral regional blocks in sedated or anesthetized patients. However, there has been no evidence of applying PI for predicting the success of nerve block in general anesthetized patients.
Interventions
PROCEDUREInterscalene brachial plexus blocks with ultrasound guidance under general anesthesia
Ultrasound-guidance, interscalene brachial plexus blocks, in-plane technique, perineural injection, 0.5% ropivacaine 12.5ml and 0.2% lidocaine 12.5ml
Sponsors
Korea University Guro Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* 20-70 years old, * BMI 20-35 kg.m-2, * elective shoulder surgery, * ASA physical status I-III
Exclusion criteria
* refusal of the patient, * comorbid with serious vascular disease, * diabetes, * allergy to local anesthetics, * patients on regular opioids, * peripheral neuropathy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perfusion Index | change between before and 15 minutes after brachial plexus block | perfusion index measured applied to both blocked and non-blocked limbs using two separate oximeters |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | change between before and 5 minutes after incision of surgical procedure | heart rate in bpm during operation |
| Blood pressure | change between before and 5 minutes after incision of surgical procedure | blood pressure in mmHg during operation |
| Pain score | 1 hour after surgery | Numeric rating scale for pain on a 0-10 scale where 0=no pain and 10=unbearable pain |
| Sensory function test on supraclavicular nerve and axillary nerve | 1 hour after surgery | 0-2 scale where 0=no block; 1=analgesia (patient can feel touch, not cold); 2=anesthesia (patient cannot feel touch) |
| Motor function test on supraclavicular nerve and axillary nerve and | 1 hour after surgery | 0-2 scale where 0 = no block; 1 = paresis; 2 = paralysis |
Countries
South Korea
Outcome results
None listed