The Effect of Interscalene Block on Intracranial Pressure

Cumhuriyet University40 enrolled

Overview

The study aims to show the effects of interscalene brachial plexus (ISBP) block on intracranial pressure by measuring optic nerve sheath diameter (ONSD) and internal vein collapsibility index (IJV-CI).

40 is the targeted number of patients who are going to have humerus fracture or opened rotator-cuff surgery. Single shot-ISBP block with 25 ml local anesthetic will be performed as anesthetic approach for surgery to all participants. Intraoperative ONSD and IJV-CI measurements will be performed before the ISBP block, 20 minutes and 60 minutes after the block. Hypothesis; external drug-volume effect on internal jugular vein causes decreasing maximum diameter of internal jugular vein (Dmax), venous return from cranium to heart decreases, intracranial pressure can increase.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Brachial Plexus Block Intracranial Pressure Increase

Interventions

Interscalene brachial plexus blockPROCEDURE

For single shot-ISBP block, 15 ml of 0.5% bupivacaine + 10 ml of 2% prilocaine, a total of 25 ml of local anesthetic, will be administered to all patients. For the block procedure, an imaginary horizontal line drawn from the thyroid cartilage to the sternocleidomastoid (SCM) muscle will followed and the lateral of the SCM muscle will be cleaned with povidine iodine. At the C6 level to be blocked, the nerve roots will be detected by ultrasound. 25 ml of local anesthetic will be injected around the plexus roots with a 22 G 80 mm echogenic needle. The distribution of the local anesthetic applied to the area, which expands the tissues and separates the nerve roots from other tissues, will be seen on ultrasound.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who had elective humeral fracture and open rotator-cuff surgery, * Patients aged 18-85 years, * Patients have ASA I-II anesthesia risk according to the American Society of Anesthesiologists (ASA) risk classification, * Patients that gave consent for participation in the study will be included. Exclusion Criteria: * Patients who do not give consent to the study, * Patients with infection and open wounds in the area of skin puncture and eyelids, * Patients have any history of intracranial pathology, * Patients have nerve blockade contraindications such as coagulation disorder and antithrombotic-anticoagulant use, * Patients have a history of allergy to one of the study drugs, * Patients have a body mass index over 35 kg/m2, * Patients with contralateral pneumothorax, * Patients with severe respiratory distress, * Patients with uncontrolled hypertension, * Patients with acute or chronic eye disease, * Patients with previous eye surgery, * Patients using a beta-blocker known to increase intraocular pressure, * Patients using calcium channel blockers, statins and nitrates, * Patients in need of intraoperative sedation, * Patients who develope any complications (hoarseness, horner's syndrome, respiratory distress, local anesthetic toxicity) due to ISBP block will be excluded from the study.

Locations (1)

Sivas Cumhuriyet University

Sivas, Turkey (Türkiye)

RECRUITING

Outcomes

Primary Outcomes

Optic nerve sheath diameter change

Optic nerve sheath diameter will be measured as a unit of millimeter.

Time frame: Optic nerve sheath diameter will be measured before the block (basal) and it will be measured at 20th and 60th minutes after the block. The change between the measurements of basal and 60th minute and change between basal and 20th minute will be assessed

Internal jugular vein collapsibility index (IJV-CI) change

IJV-CI will be measured as a unit of %.

Time frame: IJV-CI will be measured before the block (basal) and it will be measured at 20th and 60th minutes after the block. The change between the measurements of basal and 60th minute, and change between basal and 20th minute will be assessed

Maximum diameter of internal jugular vein (Dmax) change

Dmax will be measured as a unit of millimeter

Time frame: Dmax will be measured before the block (basal) and it will be measured at 20th and 60th minutes after the block. The change between the measurements of basal and 60th minute, and change between basal and 20th minute will be assessed

Minimum diameter of internal jugular vein (Dmin) change

Dmin will be measured as a unit of millimeter

Time frame: Dmin will be measured before the block (basal) and it will be measured at 20th and 60th minutes after the block. The change between the measurements of basal and 60th minute, and change between basal and 20th minute will be assessed

Central Contacts

Oğuz Gündoğdu

CONTACT

+905545945469 oguzgundogdu87@gmail.com

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.