Other Surgical Procedures Clinical Trial
Official title:
Ultrasound-guided Block of the Brachial Plexus Using Prilocaine: Effects of Local-anesthetic Dose Reduction on Parameters of Block Quality and Adverse Effects in Outpatients
Clinical aim: Does reducing the dose of local anesthetic in ultrasound-guided axillary plexus anesthesia have any effect on the success rate and additional parameters of block quality? Methodology: In this prospective cohort study three groups of 40 outpatients each were administered dosages of 1% prilocaine of either 40mL, 30mL or 20mL for axillary plexus anesthesia. Met-Hb was measured prior to administration of the block and then hourly until the Met-Hb concentration fell. Parameters of block quality and any adverse effects were recorded. The level of significance was defined with α ≤ 0.05.
Status | Completed |
Enrollment | 120 |
Est. completion date | April 2010 |
Est. primary completion date | April 2010 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 75 Years |
Eligibility |
Inclusion Criteria: - elective surgery on the distal forearm or the hand - adult outpatients, age 18-75 years old - ASA-risk groups I-II (American Society of Anesthesiologists) - Body Mass Index 17-35 - informed consent Exclusion Criteria: - severe coagulopathy - local or systemic inflammatory response - ASA-risk groups = Grad III - severe anemia - heart failure - manifest shock - other drugs with influence on methaemoglobinemia (nitrates, sulfonamides etc.) - domestic care after surgery not ensured - drug allergy : local anesthetics - severe polyneuropathy - pregnancy, lactation period - participation in other studies - non-cooperative patients - addiction to drugs or alcohol |
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Helios Research Center |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of Participants With Complete Sensory Block | The number of outpatients with complete sensory block of all 4 nerves (n.musculocutaneous, n.radialis, n.ulnaris,n.medianus) was registrated in each group. | 60 minutes after administration of the local anesthetic | No |
Primary | Number of Participants With Complete Motor Blocks | To examine the extent of the motor block the manual muscle function test after Vladimir Janda was used. As a complete motor block was defined, when no motion (grade zero after Janda) of muscles innervated by the four blocked nerves (musculocutaneous, median, radial and ulnar nerve) was observed within 60 minutes after administration of the local anesthetic. | Within 60 minutes after administration of the local anesthetic | No |
Primary | Onset Time. | Time from beginning of administration of the local anesthetic until complete sensoric block. | within 60 minutes after administration of the local anesthetic | No |
Secondary | Maximum Concentrations of Methemoglobin | Concentration of Methemoglobin (Met-Hb) was measured using spectrophotometry prior to the anesthesia (baseline value) and then hourly after performing the block until a clear decrease became apparent. The maximum amount was reached in every case two or three hours after administration of the local anesthetic. | 0,1,2,3,4 hours post-dose | Yes |
Secondary | Number of Participants With Objective Adverse Events as a Measure of Safety and Tolerability | In groups A, B and C was determined the rate of objective clinical signs of increased Met-Hb-levels : drops in oxygen saturation <93% using pulseoximetry or lip cyanosis. | Outpatients were followed for the duration of hospital stay, an average of six hours. | Yes |
Secondary | Number of Participants With Subjective Adverse Events as a Measure of Safety and Tolerability. | In groups A, B and C was determined the rate of subjective clinical signs of increased Met-Hb-Levels : headaches or dizziness, when correlated with the peak-Met-Hb-Level. | Outpatients were followed for the duration of hospital stay, an average of six hours. | Yes |
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