Ultrasound-guided Nerve Block: Determination of the Minimal Effective Volume of Local Anesthetic

Hopital Foch52 enrolled

Overview

Ultrasound guidance can reduce the required local anesthetic volume for successful peripheral nerve block. The aim of the study is to determine the minimum volume of local anesthetic to achieve an ultrasound-guided median nerve block with a dextrose 5% hydrodissection approach.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Surgery

Interventions

median nerve blockPROCEDURE

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * aged 18 years from 18 to 80 years with an ASA (American Society of Anesthesiologists) physical status I-II * elective hand ambulatory surgery with a maximum duration of 30 minutes involving the median nerve and performed with elbow nerve blocks Exclusion Criteria: * pregnant or lactating women, * contra-indication to regional anesthesia * diabetes mellitus, * effective anticoagulation or antiplatelet therapy, laboratory evidence of abnormal bleeding * neurological disease ( including carpal tunnel syndrome or neuromuscular disease detected by preoperative neurological examination in the median nerve) * infection at the puncture site * contra-indication to the administration of lidocaine, notably allergy * contra-indication to the administration of lidocaine with epinephrine * not speaking French Exclusion from the study: * patient having an intraneural injection of the median nerve defined by swelling appearance are excluded from analysis

Locations (2)

Centre Hospitalier de la Côte Basque

Bayonne, France

Hopital privé de l'Ouest Parisien

Trappes, France

Outcomes

Primary Outcomes

Minimal effective volume of local anesthetic

Effective volume of local anesthetic to obtain a successful median nerve block block in 95% of patients defined as complete light touch block at the palmar aspect of the 2 distal phalanges of the index finger during a 30 minute evaluation period (mL)

Time frame: 1 hour

Secondary Outcomes

Nerve block onset time

Onset time for complete cold light touch and motor block at 30 min and 45 min.

Time frame: 1 hour

Success rate of the median nerve block

Success rate concerns: * success rate of sensitive block: complete cold and light touch block at 30 min and 45 min at the palmar aspect of the 2 distal phalanges of the index finger and on the thenar eminence * success rate of motor block: complete motor block at 30 min and 45 min

Time frame: 1 hour

Additional local anesthetic

* Percentage of cases where additional local anesthetic was necessary before the incision (%), i.e; performed by anesthesiologist * Percentage of cases where additional local anesthetic was necessary after the incision (%), i.e; performed by surgeon

Time frame: 2 hours

Duration of analgesia

Time to first analgesic requirement (minutes)

Time frame: 1 day

Duration of the block

Delay between the completion of the block and the returned to normal onset of sensory and motor recovery of the first three fingers of the hand) (minutes)

Time frame: 1 day

Complications

Data from ClinicalTrials.gov

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