Can the Femoral Nerve Block be Improved by Ultrasound Guidance?
- Conditions
- Pain
- Interventions
- Procedure: loss of resistanceProcedure: determination of method with highest efficacy (ultrasound or nerve stimulator)Procedure: nerve stimulator
- Registration Number
- NCT00696150
- Lead Sponsor
- NHS Greater Glasgow and Clyde
- Brief Summary
Studies have suggested a link with effective pain relief and reduced illness and death in very unwell patients. This study will determine the most effective method of injecting local anaesthetic around the nerves which supply the hip joint. Local anaesthetic will be injected around the hips nerve supply using either ultrasound, loss of resistance or electrical nerve stimulator to guide the positioning of the needle on patients due for elective total hip replacement. The patient will then be observed for 30 minutes and the patient ability to move or feel the upper leg will recorded. A standard anaesthetic and a hip replacement operation will then be performed. Standard pain relief protocols will be used the operation and after the operation. After the operation we will record the amount of morphine used and how happy the patients have been with their treatment at 6 hours after the operation and at 24 hours after the operation. The first day the patient is able to walk on their new hip replacement will also be recorded.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 269
- Elective primary total hip arthroplasty under general anaesthesia
- ASA<=4
- Able to give informed consent
- Able to cooperate with sensory and motor testing of lower limb function
- Abnormal clotting screen (coagulopathy) or thrombocytopenia (<100,000)
- Acute mental test score of <=7 at any time pre or post operatively
- Allergy to local anaesthetic
- Signs, symptoms or laboratory evidence of local infection or systemic sepsis
- No pre-existing neurological deficit (sensory or motor) affecting lower limb
- Patients with lower limb amputations
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description loss of resistance loss of resistance Anterior psoas compartment nerve block inserted using loss of resistance nerve stimulator determination of method with highest efficacy (ultrasound or nerve stimulator) Anterior psoas compartment nerve block inserted using nerve stimulator nerve stimulator nerve stimulator Anterior psoas compartment nerve block inserted using nerve stimulator ultrasound determination of method with highest efficacy (ultrasound or nerve stimulator) Anterior psoas compartment nerve block inserted using ultrasound
- Primary Outcome Measures
Name Time Method percentage of patients with effective regional analgesia Induction of anaesthesia
- Secondary Outcome Measures
Name Time Method acute mental test scores 6hours and 24 hours post operatively sensory function of femoral nerve 0mins, 10mins, 20mins after insertion of local anesthetic sensory function in lateral cutaneous nerve 0mins, 10mins 20mins post insertion of local anaesthetic sensory function of obturator nerve 0mins, 10mins, 20mins after insertion of local anesthetic motor function of obturator nerve 0mins, 10mins and 20minutes after insrtion of local anesthetic day first mobilise post operatively post operatively 0-10 days patient satisfaction scores 6 hours and 24hours post operatively hospital mortality 1months after operation total morphine dose administered 6hours and 24 hours post operstively motor function of femoral nerve 0mins,10mins and 20mins post insertion of local anesthetic
Trial Locations
- Locations (4)
Gartnavel General hospital
🇬🇧Glasgow, Lanarkshire, United Kingdom
Royal alexandra hospital
🇬🇧Paisley, Renfrewshire, United Kingdom
Glasgow Royal Infrimary
🇬🇧Glasgow, Lanarkshire, United Kingdom
Golden Jubilee hospital
🇬🇧Glasgow, Lanarkshire, United Kingdom