We hypothesize that ultrasound visualization of the distal sciatic nerve with subsequent ultrasound guided injection of a reduced amount of local anesthetic will result in shorter performance times, equivalent block quality (sensory and motor onset…
ID
Source
Brief title
Condition
- Procedural related injuries and complications NEC
- Nervous system, skull and spine therapeutic procedures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The amount of injected local anesthetic
Successrate
Block characteristics (onset time and duration)
Secondary outcome
Block procedure time
Attempts to localize the nerve
Blockprocedure related pain
Patient satisfaction
Neurologic complications
Background summary
Ultrasound guidance for peripheral nerve blocks have been described for
brachial plexus and femoral nerve blocks. The reports showed that ultrasound
guidance improved the successrate and onset time and reduced the amount of
local anesthetic and had few complications compared with the nerve stimulation
guided techniques. Recently it is described that ultrasound assisted sciatic
nerve localization is potentially valuable for sciatic nerve blocks.
Study objective
We hypothesize that ultrasound visualization of the distal sciatic nerve with
subsequent ultrasound guided injection of a reduced amount of local anesthetic
will result in shorter performance times, equivalent block quality (sensory and
motor onset time and duration) and less patient discomfort compared with the
present technique. (nerve stimulation guided distal sciatic nerve block)
Study design
A prospective randomized single blinded interventional study.
Intervention
In the ultrasound guided distal sciatic nerve blocks, the sciatic nerve will be
visualised, hereafter under direct ultrasound guidance the needle will be
introduced. Needle position will be confirmed by electrical nerve stimulation.
Under ultrasonographic control local anesthetic is injected. If no
circumferential spread occurs around the nerve, the needle will be repositioned
in order to obtain this pattern of spread of local anesthetic.
In the nerve stimulation group, the needle insertion point is determined based
on anatomical reference points. By electrical nerve stimulation the exact
needle position is determined and hereafter local anesthetic is blindly
injected.
Study burden and risks
The risks the patient faces when participating in this research project are not
different compared to the normal clinical situation when a distal sciatic nerve
block is performed for surgical anesthesia of the lower leg or foot.
In daily clinical practice the following incidents are routinely tried to
avoid: intoxication with local anesthetic due to resorption or intravascular
injection and intraneural injection with subsequent mostly temporary nerve
damage.
Postbus 9101
6500 HB Nijmegen
Nederland
Postbus 9101
6500 HB Nijmegen
Nederland
Listed location countries
Age
Inclusion criteria
Patients, (ASA 1 to 3) undergoing surgery of the lower limb or foot under locoregional anesthesia with a distal sciatic nerve block.
Exclusion criteria
hepatic and or renal disease, pregnancy, allergy for local anesthetics, inability to communicate adequately
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL12334.091.06 |