The purpose of this study is to determine the minimum effective volume of local anesthetic for interscalene brachial plexus block using ultrasound guidance and nerve stimulator guidance.
This will be a single group assignment, double-blind, up-down sequential allocation study. Interscalene brachial plexus block (ISBPB) is a common nerve block given to patients who are undergoing shoulder surgery. This block has a low, but still significant, rate of complications. Reducing the volume of local anesthetic given during the block may allow some of these complications to be avoided. Participants will undergo ISBPB under ultrasound and nerve stimulator guidance. Patients will initially receive 15mL of local anesthetic (bupivacaine 0.5% with epinephrine). The volume used for each subsequent patient depends upon the success or failure of the previous patient's block - a failure will cause the volume given to increase by 1.0 mL, while a success will cause the volume to decrease by the same amount. The goal of this study is to determine the minimum effective anesthetic volume of bupivacaine 0.5% providing anesthesia in patients when using ultrasound and nerve stimulator to guide placement of the block. The secondary outcome will be the evaluation of diaphragmatic function and post-surgery analgesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
33
Patients will be given bupivacaine 0.5% in different doses (up-down study).
Luiz Fernando dos Reis Falcao
São Paulo, São Paulo, Brazil
ED95 of bupivacaine minimum effective volume
The ED95 of bupivacaine minimum effective volume determination in interscalene brachial plexus block using ultrasound guidance. \[ Time Frame: every 10 minutes until 30 minutes, after 4 hours and after 6 hours post-block \]
Time frame: ED95
Diaphragmatic Function
Diaphragmatic Function (as assessed by diaphragmatic movement on ultrasound) \[ Time Frame: after 30 minutes, 4 hours and 6 hours post-block \]
Time frame: Diaphragmatic
Post-surgery analgesia
Post-surgery analgesia \[ Time Frame: after 4 hours and 6 hours post-block \]
Time frame: Analgesia
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.