View clinical trials related to Regional Anesthesia.
Filter by:The achievement of peripheral nerve block requires several needle passes, with each of them being at risk of causing nerve injury either by direct trauma or intraneural injection even with the use of the ultrasound. The ultrasound guided supraclavicular brachial plexus block is known to be at risk of pneumothorax and / or nerve injury. This study is designed to determine the maximal effective distance away from the nerve for the injection to be effective.
The use of Ultrasound Guided Regional Anaesthesia (USRA) has increased over the last decade. Theoretically, ultrasound imaging may increase efficacy and safety by allowing visualization of the needle pathway and local anaesthetic spread around the nerve. In addition to knowledge of anatomy and general principles of ultrasonography, USRA requires learning new skills such as image interpretation, needle-beam alignment, and needle trajectory tracking. The hand-eye coordination required during needle advancement requires practice to master because the needle must be properly aligned with the ultrasound probe in order to maintain the needle path in the beam at all times. Adding to the difficulty, hand and needle movements can occur in three axes, but an ultrasound image is seen in only two dimensions. Since the ability to acquire the necessary skills to perform USRA is subjective and not yet validated, it is difficult to recommend a single, effective training pathway. Currently, the only method of supervised training before performing an USRA procedure on an actual patient involves practicing needle insertion in a phantom or cadaver. Studies assessing the impact of learning using these methods are lacking. It is possible that some practitioners may choose alternative one-off learning methods. Such methods are not standardized and are thus difficult to evaluate.
Aim oft he study is to compare two different devices for cerebral oximetry (FORE-SIGHTTM Monitor (CAS Medical Systems, Branford, Connecticut, USA and INVOSTM Somanetics, Troy, Michigan, USA) in patients undergoing surgical carotid thrombendarterectomy (cTEA) with crossclamped internal carotid artery (ACI). All procedures will be performed in regional anesthesia, therefore the patients will be awake and direct neurological examination during the procedure will be possible, giving information how the drop in cerebral saturation (measured with INVOS and FORESIGHT both on the same patient) correlates with any clinical symptoms. We expect to see a difference in the total drop and in the delay of the drop of cerebral oxygen saturation, making it possible to detect varieties in specificity and sensitivity of both devices compared to neurologic examination in the awake patient.
Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery. A randomized controlled double blinded MRI study comparing long versus short axis catheter placement. Which procedure for insertion of nerve catheters for postoperative pain after major foot and ankle surgery is the best
The purpose of this research study is to evaluate the analgesic efficacy of adding a single shot parasacral (sciatic) nerve block to a continuous lumbar plexus block in patients undergoing total hip replacement.
Injecting local anesthetic to anesthetize a nerve or group of nerves (a 'nerve block') is an effective way to eliminate pain during and after surgery. There are instances when it would be beneficial to the patient for the nerve block to be resolved quickly rather than waiting for it to naturally wear off. For example, a sciatic nerve block that freezes the lower leg and foot typically takes over 18 hours to resolve on its own, and both the surgeon and patient prefer to have motor function before discharge. The investigators wish to perform a randomized, controlled trial to determine if infusion of a solution such as saline to 'wash out' the nerve block after surgery can allow the patient to be pain-free while still being able to move their leg and foot.
This prospective, randomized, double blinded, placebo-controlled study is designed to evaluate the postoperative analgesic efficacy of the ultrasound-guided transversus abdominis plane block with ropivacaine 0,75 %, in patients undergoing unilateral inguinal hernia repair with a mesh under general anaesthesia, and how the efficiency of early postoperative analgesia achieved correlates with the risk of developing a chronic pain state, a not uncommon condition after this type of surgery.
This study will compare the infiltrative transversusabdominis plane (TAP) block with liposomal bupivacaine to epidural analgesia (EA) in major abdominal surgery . The efficacy of the TAP block for abdominal surgery is well documented in literature, but there are no studies utilizing long-acting bupivacaine. The investigators believe the study will demonstrate no difference between the two in terms of pain scores and opioid consumption, but TAP blocks will decreased costs, urinary retention, and hypotension.
Following foot and ankle surgery, ultrasound-guided sciatic nerve block (SNB) at the popliteal fossa decreases post-operative pain and opioid consumption. At the popliteal fossa, the sciatic nerve bifurcates to form the Common Peroneal Nerve (CPN) and Tibial Nerve (TN). Studies have shown that when both branches are blocked separately distal to the bifurcation site, block onset time is reduced by 30%. Through clinical observation, the investigators found that onset time is further shortened when ultrasound-guided SNB is performed at the site of bifurcation. This is because the local anesthetic spreads interneurally. The purpose of this study is to compare the block onset time of an ultrasound-guided sciatic nerve block at the site of nerve bifurcation with the blockade of each terminal nerve separately (TN and CPN) distal to sciatic nerve bifurcation.
Patients experience significant postoperative pain following shoulder surgery, Single shot interscalene block is used in ambulatory shoulder surgery for its advantages that include significant reduction in acute pain and analgesic requirements, prolonged time to first analgesic request, decreased incidence of nausea, as well as earlier hospital discharge.The process of nerve block requires several needle passes, with each of them being at risk of causing nerve injury either by direct trauma or intraneural injection even with the use of the ultrasound. These facts raised concerns and several authors stated that maybe the anesthesiologists should be more careful, keep a safe distance from the nerve, and inject the local anesthetics into fascial planes containing the nerve and not attempt to place the needle in close proximity to the nerve. This study is designed to determine the maximal effective distance away from the nerve for the injection to be effective.