Intracranial Pressure Increase Clinical Trial
Official title:
Evaluation of Supraclavicular Brachial Plexus Blocks at Different Volumes Under Ultrasound Guidance in Upper Extremity Surgery and Their Impact on Optic Nerve Sheath Diameter
This study aimed to evaluate the anesthesia adequacy, side effects, and complication rates, as well as the postoperative pain relief effectiveness of supraclavicular brachial plexus blocks administered at different volumes under ultrasound guidance. Additionally, the investigators utilized ultrasound to measure optic nerve sheath diameters and investigated their relationship with intracranial pressure across varying block volumes.
Status | Not yet recruiting |
Enrollment | 64 |
Est. completion date | September 3, 2024 |
Est. primary completion date | August 3, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 50 Years |
Eligibility | Inclusion Criteria: - Patients aged between 18 and 50, of both genders, with planned surgery on the finger, wrist, elbow joint, and distal region, and classified as ASA I-II, will be included in the study. In this study, patients will be informed about the anesthesia method and the tests to be conducted, and those who consent will be asked to sign an informed consent form as voluntary participants. Exclusion Criteria: - Patients who do not accept the procedures and tests - Those with diseases that may cause increased intracranial pressure - Patients with severe heart failure - Patients with second or third degree atrioventricular block - Patients with unstable angina history - Patients with COPD and chronic asthma - Patients with a history of myocardial infarction (MI) within the last 6 weeks - Patients with a heart rate below 50 beats/min - Patients with systolic blood pressure below 90 mmHg - Patients with liver failure - Patients with kidney failure - Patients for whom supraclavicular block anatomically cannot be performed - Those with neurological or psychological diseases that make it difficult to assess the tests - Patients allergic to any of the study drugs - Pregnant women |
Country | Name | City | State |
---|---|---|---|
Turkey | Pamukkale University | Denizli | Pamukkale |
Lead Sponsor | Collaborator |
---|---|
Pamukkale University |
Turkey,
Gundogdu O, Avci O. Evaluation of the Effect of Interscalene Brachial Plexus Block on Intracranial Pressure Using Optic Nerve Sheath Diameter and Internal Jugular vein Collapsibility Index. J Coll Physicians Surg Pak. 2022 Oct;32(10):1249-1254. doi: 10.29271/jcpsp.2022.10.1249. — View Citation
Hylkema C. Optic Nerve Sheath Diameter Ultrasound and the Diagnosis of Increased Intracranial Pressure. Crit Care Nurs Clin North Am. 2016 Mar;28(1):95-9. doi: 10.1016/j.cnc.2015.10.005. Epub 2015 Dec 23. — View Citation
Pansell J, Bell M, Rudberg P, Friman O, Cooray C. Optic nerve sheath diameter measurement by ultrasound: Evaluation of a standardized protocol. J Neuroimaging. 2022 Jan;32(1):104-110. doi: 10.1111/jon.12936. Epub 2021 Sep 23. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Optic nerve sheath diameter measured by ultrasonography | Optic nerve sheath diameter will be measured using B-mode ultrasonography. | Before block, After block 20 minutes, After block 60 minutes | |
Secondary | Perfusion index (PI) | PI, an objective method different from traditional tests, to determine the success of peripheral nerve block. PI is an indicator of peripheral perfusion that can be measured continuously and non-invasively with a pulse oximeter. PI is the ratio of pulsatile blood flow to non-pulsatile blood flow in peripheral tissue. Its normal value ranges from 0.02 to 20. After peripheral nerve block, vasodilation occurs in the vessels due to sympathetic blockade, resulting in an increase in PI values, which occurs earlier than motor and sensory block. PI monitoring provides more objective results for evaluating the onset of the block. The cut-off value indicating that the block is successful is a PI increase to 3.03 times the baseline value 10 minutes after the block is administered. | The PI values will be measured and recorded at 0, 2, 4, 6, 8, 10, 15, 20, and 25 minutes in both arms. | |
Secondary | Non-invazive end-tidal carbon dioxide (EtCO2) | Non-invasive EtCO2 measurement is a method used to monitor the concentration of carbon dioxide (CO2) at the end of expiration. | EtCO2 will be measured and recorded at 0, 10, 20, 30, 60 minutes, and at the end of surgery after the block is performed. | |
Secondary | Pinprick test | The pinprick test is a clinical procedure used to evaluate sensory nerve function. A small, sharp object, such as a pin or needle, is gently pressed against the skin to assess the patient's ability to feel pain. | The pinprick test will be evaluated 5 minutes after the block is performed and subsequently at 5-minute intervals, up to a maximum of 30 minutes. The results will be recorded throughout these evaluations. | |
Secondary | Modified Bromage Scale | The Modified Bromage Scale is a clinical tool used to assess the degree of motor block in patients who have received regional anesthesia. The scale ranges from 0 to 3, with each level indicating a different degree of motor impairment:
0: No motor block; full flexion of knees and feet. 1: Partial motor block; able to move knees but not feet. 2: Almost complete motor block; able to move feet only. 3: Complete motor block; unable to move knees or feet. |
The Modified Bromage Scale will be evaluated 5 minutes after the block is performed and subsequently at 5-minute intervals, up to a maximum of 30 minutes. The results will be recorded throughout these evaluations. | |
Secondary | Verbal Pain Score | The Verbal Pain Score is a subjective measure used to assess a patient's level of pain. Patients are asked to rate their pain on a scale from 0 to 10, where 0 indicates no pain and 10 represents the worst pain imaginable. | The Verbal Pain Score will be assessed at the following intervals after surgery: immediately in the recovery room, at 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours postoperatively. |
Status | Clinical Trial | Phase | |
---|---|---|---|
Not yet recruiting |
NCT03227354 -
Validation of Non-invasive Absolute Intracranial Pressure Monitoring
|
N/A | |
Completed |
NCT03641443 -
non_invasive_aICP_Tumor
|
N/A | |
Completed |
NCT06451289 -
Study on Optic Nerve Sheath Diameter Measurements in Prolonged Pediatric Seizures
|
||
Not yet recruiting |
NCT03828032 -
Multi-parameters'Change Process During Dehydration Therapy on Brain Edema Patients.
|
N/A | |
Terminated |
NCT03286426 -
Ocular Screening in Children and Young Adults at Risk for Increased Intracranial Pressure
|
N/A | |
Completed |
NCT03782077 -
Change of Optic Nerve Sheath Diameter After Deflation of Pneumatic Tourniquet
|
||
Recruiting |
NCT06288659 -
aSAH Treatment Based on Intraventricular ICP Monitoring: A Prospective, Multicenter, Randomized and Controlled Trial
|
N/A | |
Completed |
NCT03195881 -
Neuroprognostication Using Optic Nerve Sheath Diameter
|
||
Completed |
NCT04446013 -
Comparison of ONSD and rSO2 Measurements Between General and Spinal Anesthesia in C-Section
|
N/A | |
Completed |
NCT03418753 -
Non-invasive Diagnostic for Assessing Elevated Intracranial Pressure
|
||
Recruiting |
NCT06403592 -
The Effect of a Laryngeal Mask Airway on Optic Nerve Sheath Diameter
|
||
Active, not recruiting |
NCT05609071 -
Technology of Intracranial Pressure Estimation by Single-Channel EEG in Brain Disease
|
||
Completed |
NCT05286697 -
The Effect of Optic Nerve Diameter on Postoperative Cognitive Function in Laparoscopic Hysterectomy
|
N/A | |
Completed |
NCT06048900 -
Evaluation of the Effect of Trendelenburg Position Duration on Intracranial Pressure
|
N/A | |
Active, not recruiting |
NCT05731765 -
SVP Detection Using Machine Learning
|
||
Recruiting |
NCT05346471 -
Infra- and Supratentorial Neuromonitoring
|
N/A | |
Recruiting |
NCT06464419 -
Effect of Lithotomy Position on Optic Nerve Sheath Diameter
|
||
Recruiting |
NCT03344432 -
Correlation Intraocular Pressure With Intracranial Pressure
|
N/A | |
Recruiting |
NCT05931991 -
Intra-operative Evaluation of the External Ventricular Drain Catheter Position With Structured Light for Patients (Bullseye EVD)
|
||
Completed |
NCT04004923 -
Intracranial Pressure in Monopolar and Bipolar Hysteroscopy
|
N/A |