Combined Lumbar and Sacral Branches Block Through the Ilio-Psoas Muscle Spaces for Analgesia of Lower Limb Surgeries

N/ACompletedNCT06019754

Zagazig University56 enrolled

Overview

lumbosacral plexus block (LSPB) has been widely applied in orthopedics departments due to its advantages, including reduction in the application of opiates, decreasing the occurrence of acute pain, promoting early activation, and shortening the time of hospital stay. LSPB is a peripheral regional technique of anesthesia and analgesia, that provides a block of the main components of the lumbosacral plexus.

Traditional ultrasound-guided lumbar plexus block combined with sacral plexus block requires separate blocks at different sites, requiring the lateral decubitus or prone position, which may be suboptimal in patients with severe pain. we present an anterior approach for combined lumbar and sacral plexus blocks with a one-point puncture.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Enrollment

Conditions

Lower Limb Fracture

Interventions

one point combined Lumbar and sacral plexus blockPROCEDURE

performing an ultrasound-guided one-point combined Lumbar and sacral plexus block using a one-point puncture. Block success will be assessed using the perfusion index (PI) before and after performing the block

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * ASA I-II. * patients scheduled for unilateral femur or tibial surgery necessitate knee joint intervention * patients who have severe pain hindering changing their position or patients who have spinal fractures or refusing spinal anesthesia. * patients with the capability of communication Exclusion Criteria: * puncture site infection * patients with coagulation disorders * patients who refuse to participate or withdraw due to personal reasons * allergy to local anesthetics. * past surgery at the site of the block * hip ankylosis * drug abuse * Body mass index ≥ 35 kg/m2 * peripheral vascular insufficiency * use of alpha or beta blocker agents * Nerve injury or neuropathy of the affected lower limb * cardiovascular or respiratory decompansation

Locations (1)

Faculty of Medicine - Zagazig University

Zagazig, Egypt

Outcomes

Primary Outcomes

Total intraoperative and postoperative opioid consumption

The total fentanyl doses consumed in the entire operative procedure and morphine consumed for 24 hours postoperative will be calculated.

Time frame: Total fentanyl used intraoperative and total morphine consumed up to 24 hours postoperative

Secondary Outcomes

(NRS) score assessment pre-block, 30 min post-block , and postoperatively in the recovery room, and then it will be repeated 3 h, 6h, 12h, and 24, hours

Numerical Pain Score (NRS) ranges from 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable. Adequate pain control will be considered at Numerical Pain Score (NRS) \< 4. Pain will be assessed using (the NRS) score preoperatively before the block and 30 min post-block, then postoperatively in the recovery room, 3 h, 6h, 12h, and 24 hours.

Time frame: preoperative and postoperatively pain (NRS) score assessment for 24 hours

Block success assessment using perfusion index (PI) before and after performing the block

Perfusion index (PI) values rise with successful peripheral nerve blocks. If PI is not changed, this means block failure

Time frame: Recording Perfusion index readings at baseline and 10, 20, 30 min. post block

Data from ClinicalTrials.gov

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