Regional Changes in Upper Limb Perfusion Following Brachial Plexus Block: A Pilot Study

Nerve Block Clinical Trial

— RAFFAB  

Official title:

Regional Changes in Upper Limb Perfusion Following Brachial Plexus Block: A Pilot Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02589054
• Other study ID #: 106285
• Status: Completed
• Phase: N/A
• First received: October 22, 2015
• Last updated: March 29, 2017
• Start date: November 2015
• Est. completion date: March 2016

Study information

• Verified date: October 2015
• Source: Lawson Health Research Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Ultrasound-guided regional anesthesia is increasingly being used in the modern surgical environment to provide specific intraoperative anesthesia and postoperative analgesia. Infiltration of local anesthesics around peripheral nerves firs blocks sympathetic, then sensory, then motor nerve function. Sympathectomy-induced vasodilation following brachial plexus block results in increased skin temperature and arterial flow within minutes.

Although it has not been shown to reliably increase diameter or cross-sectional area of distal arteries, brachial plexus block does change the pattern and quantity of blood flow to the hand. Given that the magnitude of change of flow cannot be attributed to vessel radius, the investigators suspect that the more laminar fluid dynamics are due to vascular tone.

The investigators study aims to quantify alterations in physiology and peripheral vasodilator response. The investigators anticipate that axially block will significantly improve regional blood flow.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 18
• Est. completion date: March 2016
• Est. primary completion date: January 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• ASA physical status I, II, III

• BMI less than or equal to 39

• Presenting for elective upper limb surgery

• Does not meet any exclusion criteria

Exclusion Criteria:

• Age over 80

• ASA physical status IV or V

• BMI greater or equal to 40

• Language barrier precluding ability to give informed consent

• History of coagulopathy

• INR < 1.4

• Platelet count < 100

• Allergy to local anesthetics

• Known peripheral vascular disease of the upper limbs

• Amputation of one or both upper limbs, not including digits

• Peripheral neurological disease

• Does not consent to participate in study

Related Conditions & MeSH terms

• Anesthesia, Conduction
• Nerve Block
• Regional Blood Flow
• Sympathectomy

Intervention

Other:
• Monitoring

Locations

Country	Name	City	State
n/a

Sponsors (4)

Lead Sponsor	Collaborator
Lawson Health Research Institute	London Health Sciences Centre, St. Joseph's Health Care London, University of Western Ontario, Canada

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Changes in regional blood flow and perfusion characteristics in the upper arm arteries from baseline to 20 minutes after unilateral axillary block.	Physiologic parameter	30 minutes
Secondary	Changes in the caliber of the arteries of the arm between arms from baseline to 20 minutes after unilateral axillary block.	Physiologic parameter	30 minutes
Secondary	Changes in skin temperature between hands from baseline to 20 minutes after unilateral axillary block.	Physiologic parameter	30 minutes
Secondary	Sensory loss in radial, ulnar, and median nerve distribution between hands from baseline to 20 minutes after unilateral axillary block.	Physical examination	30 minutes
Secondary	Motor weakness in radial, ulnar, and median nerve distributions between hands from baseline to 20 minutes after unilateral axillary block	Physical examination	30 Minutes