Regional Nerve Block for Upper Extremity Surgery in Patients With Sarcopenia
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- time to first rescue analgesia
Study Overview
Brief Summary
The goal of this observational study is to learn about the impact of sarcopenia (muscle loss) on the efficacy of regional nerve blocks and postoperative recovery in patients undergoing upper extremity surgery. The main questions it aims to answer are:
- Does sarcopenia affect the onset time and success rate of peripheral nerve blocks?
- How does sarcopenia influence postoperative pain control and opioid consumption compared to patients receiving pure general anesthesia?
Participants will undergo a preoperative muscle assessment, which includes a chair stand test and a brief ultrasound of the thigh muscle. Researchers will then observe and record their nerve block onset time (if applicable), postoperative pain scores, and recovery metrics during their hospital stay up to postoperative day 2.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 50 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age>=50 years old
- •ASA I-III
- •Receiving upper limb surgery under general anesthesia
Exclusion Criteria
- •Severe cognitive impairment or inability to cooperate with pain and motor assessment
- •Pre-existing neuropathy of the musculocutaneous, median, radial or ulnar nerve
- •(for nerve block group) Contraindications to regional nerve blockade
Arms & Interventions
General anesthesia alone
Intervention: sarcopenia (Other)
General anesthesia alone
Intervention: Non-sarcopenia (Other)
General anesthesia alone
Intervention: General Anesthesia (Procedure)
General anesthesia combine infraclavicular brachial plexus block, with sarcopenia
Intervention: sarcopenia (Other)
General anesthesia combine infraclavicular brachial plexus block, with sarcopenia
Intervention: General Anesthesia (Procedure)
General anesthesia combine infraclavicular brachial plexus block, with sarcopenia
Intervention: Nerve Block (Procedure)
General anesthesia combine infraclavicular brachial plexus block, without sarcopenia
Intervention: Non-sarcopenia (Other)
General anesthesia combine infraclavicular brachial plexus block, without sarcopenia
Intervention: General Anesthesia (Procedure)
General anesthesia combine infraclavicular brachial plexus block, without sarcopenia
Intervention: Nerve Block (Procedure)
Outcomes
Primary Outcomes
time to first rescue analgesia
Time Frame: From the completion of surgery up to Postoperative Day 2
Secondary Outcomes
- Postoperative NRSFrom the end of surgery up to 48 hours postoperatively.(From the end of surgery up to postoperative day 2)
- Total opioid consumption(From the end of surgery up to postoperative day 2)
- Nerve block onset(From the completion of local anesthetic injection up to 30 minutes)
- Nerve block duration(From the successful onset of sensory block to the patient's first report of pain at the surgical site, assessed up to postoperatively day 2)
- Intraoperative Mean Arterial Pressure (MAP) and Heart Rate (HR)(During surgery (From the induction of anesthesia to the end of surgery, an average of 2 hours))
- Incidence of Local Anesthetic Systemic Toxicity (LAST)(From the initiation of nerve block up to 24 hours postoperatively)
- Incidence of postoperative delirium(From the end of surgery up to postoperative day 2)
- ICU stay(From ICU admission up to postoperative day 2)