Ultrasound-assisted Shamrock Method for Lumbar Plexus Nerve Block in Elderly Trauma Patients, Revisited.

Attikon Hospital48 enrolled

Overview

A revised ultrasound-guided approach to the lumbar plexus is investigated as for efficacy and safety in elderly trauma patients undergoing operations of the lower extremeties.

A modified ultrasound-guided Shamrock approach combined to nerve stimulation of the lumbar plexus is going to be investigated, in elderly trauma patients undergoing procedures of the lower extremities. The technique is going to be assessed as for its safety and its accuracy in localization of the plexus, by multiple measurements of the imaging time and needling time, In addition, efficacy and complications will be recorded and assessed during the immediate postoperative period.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Postoperative Pain

Interventions

lumbar plexus blockPROCEDURE

Patients undergoing orthopedic procedures of the lower extremeties are going to be studied. A modified Shamrock approach of the lumbar plexus is going to be used for postoperative analgesia, using an ultrasound-guided technique combined to a nerve stimulatior. The technique is going to be assessed as for accuracy, and safety.

Eligibility

Sex: ALLMin age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing orthopedic trauma operations of the lower extremeties * Age \>70 years old Exclusion Criteria: * Preexisting neuropathy of Lumbar plexus * Coagulopathy (assessed by history and physical examination and, if deemed clinically necessary, by blood work up ie platelets ≤ 100, International Normalized Ratio ≥ 1.4 or prothrombin time ≥ 50) * Allergy to local anaesthetics * Prior surgery at the lumbar region

Locations (1)

Attikon Hospital

Athens, Greece

Outcomes

Primary Outcomes

Time required to localize the lumbar plexus

The time (in secondes) required of this modified Shamrock method to localize the lumbar plexus in the interpsoas compartment in elderly-trauma patients undergoing orthopedic procedures of the lower extremeties. Imaging time will be calculated (time to obtain appropriate imaging of the plexus) as well as needling time (time to obtain appropriate needle placement on the plexus)

Time frame: 10 minutes (from the begining of imaging procedure) (time in seconds to localize the plexus)

Complications from lumbar plexus blockade

Safety of the modified Shamrock method of lumbar plexus blockade in elderly-trauma patients undergoing orthopedic procedures of the lower extremeties. All possible complications will be recorded (i.e. neurological complications, numbness, mobility disorder, haemmorhage, haematoma, e.t.c.)

Time frame: 1 month

Secondary Outcomes

Postoperative pain

Postoperative pain relief 4 hours after completion of the block (visual analogue scale 0-10). A VAS score \<4 is considered adequate.

Time frame: 4 hours (visual analogue scale 0-10 at 4 hours postoperatively)

Data from ClinicalTrials.gov

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