Ignite Creation Date:
2024-05-06 @ 11:25 AM
Last Modification Date:
2024-10-26 @ 12:45 PM
Study NCT ID:
NCT03512990
Status:
UNKNOWN
Last Update Posted:
2018-05-01
First Post:
2018-04-10
Brief Title:
Clinical And Anatomic Study Of An Ultrasound-Guided Superior Trunk Of The Brachial Plexus
Sponsor:
Federal University of São Paulo
Organization:
Federal University of São Paulo
Study Overview
Official Title:
Clinical And Anatomic Study Of An Ultrasound-Guided Selective Block Of The Superior Trunk Of The Brachial Plexus Description Of A New Approach
Status:
UNKNOWN
Status Verified Date:
2018-04
Last Known Status:
RECRUITING
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Introduction
Interscalene brachial plexus block is the most commonly performed regional anesthesia technique to promote analgesia for shoulder surgeries However one of limitations is the risk of phrenic nerve palsy despite injection of low volumes being contraindicated in patients with limited pulmonary reserve
Burckett-StLaurent et al described an alternative approach to avoid phrenic block - the superior trunk approach
In this case series the investigators suggest a modification of Burckett-StLaurents technique The objective of this study is to evaluate efficacy phrenic nerve function and contrast dispersion in cadavers after performing this new approach
Materials and methods
The study was approved by Institutional Review Board of our institution To perform the superior trunk approach described by Burckett-StLaurent C5 and C6 nerve roots are identified within the interscalene groove and traced distally to where they coalesce into the superior trunk proximal to the takeoff of the suprascapular nerve Burckett-StLaurent et al suggest spreading local anesthetic around superior trunk at this point
The investigators suggest an injection more distally where superior trunk is in costoclavicular space below omohyoid muscle proximal to the suprascapular outlet The needle is advanced below the prevertebral layer of deep cervical fascia avoiding that the tip of the needle lies in the fascial plane between investing layer of deep vertebral fascia and prevertebral layer a loose fascial plane where lymph node chain is located and may allow postero-anterior dispersion toward phrenic To guarentee right position of the tip the investigators suggest an intracluster pattern of spread
Patients scheduled for rotator cuff surgery will receive 6 mL of 05 bupivacaine in this new approach Successful block is defined as motor score of 2 on modified Bromage scale in the deltoid and bíceps absent sensation to cold and pinprick sensation in C5 and C6 dermatomes within 30 minutes of injection
To evaluate phrenic nerve diaphragmatic excursion will be assessed by ultrasonography of ipsilateral hemidiaphragm and impedance tomography Pain scores and analgesic consumption will be assessed in PACU
Moreover 6 mL of methylene blue will be injected into cadavers to evaluate if dispersion is restricted to fibers of the superior trunk and dont reach phrenic nerve
Interscalene brachial plexus block is the most commonly performed regional anesthesia technique to promote analgesia for shoulder surgeries However one of limitations is the risk of phrenic nerve palsy despite injection of low volumes being contraindicated in patients with limited pulmonary reserve
Burckett-StLaurent et al described an alternative approach to avoid phrenic block - the superior trunk approach
In this case series the investigators suggest a modification of Burckett-StLaurents technique The objective of this study is to evaluate efficacy phrenic nerve function and contrast dispersion in cadavers after performing this new approach
Materials and methods
The study was approved by Institutional Review Board of our institution To perform the superior trunk approach described by Burckett-StLaurent C5 and C6 nerve roots are identified within the interscalene groove and traced distally to where they coalesce into the superior trunk proximal to the takeoff of the suprascapular nerve Burckett-StLaurent et al suggest spreading local anesthetic around superior trunk at this point
The investigators suggest an injection more distally where superior trunk is in costoclavicular space below omohyoid muscle proximal to the suprascapular outlet The needle is advanced below the prevertebral layer of deep cervical fascia avoiding that the tip of the needle lies in the fascial plane between investing layer of deep vertebral fascia and prevertebral layer a loose fascial plane where lymph node chain is located and may allow postero-anterior dispersion toward phrenic To guarentee right position of the tip the investigators suggest an intracluster pattern of spread
Patients scheduled for rotator cuff surgery will receive 6 mL of 05 bupivacaine in this new approach Successful block is defined as motor score of 2 on modified Bromage scale in the deltoid and bíceps absent sensation to cold and pinprick sensation in C5 and C6 dermatomes within 30 minutes of injection
To evaluate phrenic nerve diaphragmatic excursion will be assessed by ultrasonography of ipsilateral hemidiaphragm and impedance tomography Pain scores and analgesic consumption will be assessed in PACU
Moreover 6 mL of methylene blue will be injected into cadavers to evaluate if dispersion is restricted to fibers of the superior trunk and dont reach phrenic nerve
Detailed Description:
None
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None