Nerve Block, Sarcopenia
Conditions
Brief summary
The goal of this observational study is to learn about the impact of sarcopenia (muscle loss) on the efficacy of regional nerve blocks and postoperative recovery in patients undergoing upper extremity surgery. The main questions it aims to answer are: 1. Does sarcopenia affect the onset time and success rate of peripheral nerve blocks? 2. How does sarcopenia influence postoperative pain control and opioid consumption compared to patients receiving pure general anesthesia? Participants will undergo a preoperative muscle assessment, which includes a chair stand test and a brief ultrasound of the thigh muscle. Researchers will then observe and record their nerve block onset time (if applicable), postoperative pain scores, and recovery metrics during their hospital stay up to postoperative day 2.
Interventions
OTHERsarcopenia
Patients identified with sarcopenia based on preoperative muscle assessment.
OTHERNon-sarcopenia
Patients with normal muscle mass based on preoperative muscle assessment.
PROCEDUREGeneral Anesthesia
received general anesthesia alone
PROCEDURENerve Block
general anesthesia combined with nerve block
Sponsors
Chang Gung Memorial Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Inclusion criteria
* Age\>=50 years old * ASA I-III * Receiving upper limb surgery under general anesthesia
Exclusion criteria
* Severe cognitive impairment or inability to cooperate with pain and motor assessment * Pre-existing neuropathy of the musculocutaneous, median, radial or ulnar nerve * (for nerve block group) Contraindications to regional nerve blockade
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| time to first rescue analgesia | From the completion of surgery up to Postoperative Day 2 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nerve block onset | From the completion of local anesthetic injection up to 30 minutes | — |
| Nerve block duration | From the successful onset of sensory block to the patient's first report of pain at the surgical site, assessed up to postoperatively day 2 | — |
| Intraoperative Mean Arterial Pressure (MAP) and Heart Rate (HR) | During surgery (From the induction of anesthesia to the end of surgery, an average of 2 hours) | Mean Arterial Pressure (MAP) measured in mmHg and Heart Rate (HR) measured in beats per minute, assessed continuously using standard non-invasive or invasive hemodynamic monitors. |
| Postoperative NRSFrom the end of surgery up to 48 hours postoperatively. | From the end of surgery up to postoperative day 2 | — |
| Total opioid consumption | From the end of surgery up to postoperative day 2 | — |
| Incidence of Local Anesthetic Systemic Toxicity (LAST) | From the initiation of nerve block up to 24 hours postoperatively | LAST is defined as the occurrence of adverse central nervous system signs (e.g., altered mental status, seizures, tinnitus) or cardiovascular signs (e.g., arrhythmias, profound hypotension, cardiac arrest) following the administration of local anesthetics. It will be assessed clinically by the attending anesthesiologist and recorded as a binary outcome (Yes/No). |
| Incidence of postoperative delirium | From the end of surgery up to postoperative day 2 | The incidence of postoperative delirium will be assessed using the Confusion Assessment Method (CAM). The CAM diagnostic algorithm evaluates four features: (1) acute onset and fluctuating course, (2) inattention, (3) disorganized thinking, and (4) altered level of consciousness. Delirium is considered present if features 1 and 2 are observed, along with either feature 3 or 4. The outcome will be recorded as a binary variable (Yes/No). |
| ICU stay | From ICU admission up to postoperative day 2 | — |
Countries
Taiwan
Contacts
PRINCIPAL_INVESTIGATORTsai
Chang Gung Memorial Hospital
CONTACTYi Ting Chen
Outcome results
None listed