Continuous Infraclavicular Nerve Blocks: Needle Versus Catheter Local Anesthetic Bolus

University of California, San Diego

Overview

The investigators propose to test the hypothesis that when placing a perineural catheter for a continuous peripheral nerve block, injecting the initial local anesthetic bolus via the insertion needle results in a faster-onset sensory block than injecting the initial bolus via the perineural catheter. The study results will help define the optimal local anesthetic bolus introduction technique-needle versus catheter-for peripheral nerve blocks when placing a perineural catheter.

Specific Aim: The investigators propose to test the hypothesis that when placing a perineural catheter for a continuous peripheral nerve block, injecting the initial local anesthetic bolus via the insertion needle results in a faster-onset sensory block than injecting the initial bolus via the perineural catheter. The study results will help define the optimal local anesthetic bolus introduction technique-needle versus catheter-for peripheral nerve blocks when placing a perineural catheter.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Conditions

Nerve Block

Interventions

Local Anesthetic given via perineural catheter for infraclavicular nerve block.PROCEDURE

Patients will be randomized to receive 30mL of Lidocaine via Catheter for an infraclavicular nerve block on one side (right or left) and via needle on the other side. Sensory and strength will be tested following local anesthetic administration.

Local Anesthetic given via needle for infraclavicular nerve blockPROCEDURE

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * age ≥ 18 years * willing to have bilateral infraclavicular blocks/catheters placed Exclusion Criteria: * current daily analgesic use * opioid use within the previous 4 weeks * any neuro-muscular deficit of either upper extremity * body mass index \> 30 kg/m2 * weight \< 50 kg \[100 lbs\] * pregnancy * incarceration

Locations (1)

UCSD CTRI, Hillcrest

San Diego, California, United States

Outcomes

Primary Outcomes

Sensory Level

EKG pads will be positioned in the 5 major nerve distributions distal to the elbow, ensuring placement is equivalent bilaterally. The primary endpoint will be the time, in minutes, until all 5 nerve territories record \> 60 mA, or 120 minutes-whichever occurs first-since 60 mA is estimated to be equivalent to a surgical incision.

Time frame: 120 minutes

Secondary Outcomes

Grip Strength

Evaluated using a portable isometric force dynamometer to measure the maximum voluntary isometric contraction (MVIC) of the hand/fingers. Subjects will be asked to take 2 sec to come to maximum effort, maintain this effort for 3 sec, and then relax.

Time frame: 120 Minutes

Sensory level for individual nerves

Evaluated using transcutaneous electrical stimulation (TES) in the same manner as described for the primary end point.

Time frame: 120 Minutes

Data from ClinicalTrials.gov

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