Anesthesia, Local
Conditions
Keywords
spinal erector block, pupillometry, loco-regional anesthesia, osteosynthesis
Brief summary
Few works have studied the area of analgesia covered by the spinal erector block in an objective manner, especially on the cephalo-caudal spread. The available data are dissection works or subjective data such as thermoalgesic or epicritic sensitivity. This information would however be relevant in order to propose a better analgesia. Indeed, it could explain certain failures by insufficient diffusion of the block. The use of a multistage block could be relevant, especially in the case of osteosynthesis on several vertebral levels.
Detailed description
Pupillometry makes possible to monitor analgesia based on the pupillary dilation reflex to pain. The goal is to establish an objective mapping of these type of analgesia from these data.
Interventions
OTHERdata collected
data collected: * Morphological data of the patients * Data of the erector block realization * Pupillometric data :the variation of the pupil size on stimulation (in percentage of the base diameter)
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients receiving erector spinae block for pain management of spinal osteosynthesis
Exclusion criteria
* Patient refusal * Known allergy to local anesthetics * Contraindication to locoregional anesthesia (haemostasis disorder, infection, peripheral neuropathy) * Technical impossibility to perform a spinal erector block * Pathology with dysautonomia altering the pupillary reflex: diabetes mellitus with diabetic retinopathy, multiple sclerosis, systemic amyloidosis, uncontrolled hypertension, glaucoma * Current treatment likely to alter pupillary dilation reflex to pain : antiemetic (droperidol, metoclopramide), alpha-2 agonist (clonidine) * Serious psychiatric history * Drug abuse * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| variation of the pupil size (in percentage) | During the surgery | Evaluation the territory covered by the spinal erector block by variation of the pupil size (in percentage). Variation of the pupil size on stimulation will allow to deduce if the dermatome is covered by the spinal erector block analgesia. |
Countries
France
Outcome results
None listed