A Cadaveric and Radiologic Study of Sacral Erector Spinae Plane Block (ESPB)

Nerve Block Clinical Trial

— ESPB  

Official title:

Comparison of Median, Intermediate and Lateral Approach to Sacral Erector Spinae Plane Block: a Cadaveric and Radiologic Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05716061
• Other study ID #: 2022/229 -13
• Status: Completed
• Phase: N/A
• Start date: February 17, 2023
• Est. completion date: March 18, 2023

Study information

• Verified date: August 2023
• Source: Giresun University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this cadaveric study is to learn about the distribution of contrast agent in ultrasound-guided sacral ESPB. The main questions it aims to answer are

1. Which nerves are affected by this block.

2. Which approach is the best for optimal analgesia in human

Description:

4 embalmed cadavers will be divided into groups of 2 and sacral ESPB will be made with 2 different methods. The cadavers will be removed from the solution 48 hours before and will be placed in the prone position, there will be no history of trauma or surgery in the sacral region of the cadavers, and no dissection will be performed from the sacral regions.

In the median approach, the probe will be placed on the cadaver, which was previously placed in the prone position, using a 12-18 megahertz high-frequency linear probe with ultrasound to form a right angle to the sacral crest. After being placed parallel to the sacrum and observing the median crest, a 50 mm echogenic needle will be inserted by advancing the implant towards the second sacral level. After touching the crest, the distribution will be observed by retreating 1mm and making 1 cc of serum physiologic. Then all 40 ml of methylene blue and radiocontrast solution will be given. In the intermediate approach; From the second sacral level, 20 ml of red acrylic dye and a solution containing radiocontrast will be given to the right and left by entering the sulcus between the median and intermedian crests with the same technique, using the same technique, under the guidance of ultrasound. After the procedure, sacral tomography will be performed on the cadavers. The spread of radiocontrast material will be observed and their reconstruction will be performed. Later, anatomical dissection will be performed on the cadavers and the spread of the dyes given will be observed. Which of the sacral intervention methods is more effective in clinical practice will be evaluated.

Estimated durations of the study;

1. Removing the cadavers from the solution 48 hours before, performing the block, going to the radiology and performing the CT scan, coming to the anatomy laboratory and performing the dissection: 3 days

2. Reconstruction and interpretation of radiology images: 1 week

3. Interpretation of anatomical dissection: 1 week

4. Evaluation and writing of the study: 1 month

Recruitment information / eligibility

• Status: Completed
• Enrollment: 4
• Est. completion date: March 18, 2023
• Est. primary completion date: March 3, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Embalmed cadaver

Exclusion Criteria:

• None of the cadavers had a history of trauma or surgery in the sacral region

Related Conditions & MeSH terms

• Nerve Block

Intervention

Procedure:
• Sacral ESPB
Cadaver study

Locations

Country	Name	City	State
Turkey	Bilge Olgun Keles	Giresun	Merkez

Sponsors (3)

Lead Sponsor	Collaborator
Giresun University	Ankara University, Karadeniz Technical University

Country where clinical trial is conducted

Turkey, 

References & Publications (6)

Aksu C, Gurkan Y. Sacral Erector Spinae Plane Block with longitudinal midline approach: Could it be the new era for pediatric postoperative analgesia? J Clin Anesth. 2020 Feb;59:38-39. doi: 10.1016/j.jclinane.2019.06.007. Epub 2019 Jun 13. No abstract ava — View Citation

Aponte A, Sala-Blanch X, Prats-Galino A, Masdeu J, Moreno LA, Sermeus LA. Anatomical evaluation of the extent of spread in the erector spinae plane block: a cadaveric study. Can J Anaesth. 2019 Aug;66(8):886-893. doi: 10.1007/s12630-019-01399-4. Epub 2019 — View Citation

Hamilton DL. The erector spinae plane block: Time for clarity over anatomical nomenclature. J Clin Anesth. 2020 Jun;62:109699. doi: 10.1016/j.jclinane.2020.109699. Epub 2020 Jan 11. No abstract available. — View Citation

Ivanusic J, Konishi Y, Barrington MJ. A Cadaveric Study Investigating the Mechanism of Action of Erector Spinae Blockade. Reg Anesth Pain Med. 2018 Aug;43(6):567-571. doi: 10.1097/AAP.0000000000000789. — View Citation

Nanda M, Allan JD, Rojas A, Steele PJ, McMillan DT, Park J, Arora H, Grant SA. Anatomic evaluation of the sacral multifidus block. J Clin Anesth. 2021 Sep;72:110263. doi: 10.1016/j.jclinane.2021.110263. Epub 2021 Apr 5. No abstract available. — View Citation

Tulgar S, Senturk O, Thomas DT, Deveci U, Ozer Z. A new technique for sensory blockage of posterior branches of sacral nerves: Ultrasound guided sacral erector spinae plane block. J Clin Anesth. 2019 Nov;57:129-130. doi: 10.1016/j.jclinane.2019.04.014. Ep — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Completion of blocks for 4 cadavers	Ultrasound guided sacral ESPB will be performed on 4 cadavers in 2 different approaches	3 days
Primary	Completion of computed tomography of 4 cadavers	Computed tomography will be taken in 4 cadavers to observe the distribution of the radiocontrast material given to 2 different regions.	3 day
Secondary	Completion of dissection of 4 cadavers	Four cadaveric specimens will be dissected in order to detect dye spread through tissue compartments	3 days