Comparison of Lateral Decubitus Position Versus Prone Position for Ultrasound Guided Posterior Lumbar Plexus Block and Sciatic Nerve Block
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Lower Limb Surgery
- Sponsor
- Huazhong University of Science and Technology
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Block success defined as loss of sensation to pinprick in each of the lumbar plexus and sciatic nerve distributions when measured 30 min after block performance.
- Status
- Completed
- Last Updated
- 15 years ago
Overview
Brief Summary
In the present study, the investigators will test the effect of two position on posterior lumbar plexus and subgluteal or sub-greater trochanter sciatic nerve block.
Detailed Description
The posterior lumbar plexus block approach was described approximately 30 years ago, using surface anatomical landmarks and a loss-of-resistance technique, but over the years it was almost abandoned for its low successful rate, the huge numbers of adverse effects and its difficulties to be performed. The introduction of the nerve stimulator and ultrasound guided technique in recent years increased the success rate in various peripheral nerve blocks and decreased adverse effects. Ultrasound guided LPB as well as sciatic nerve block technique in a small patient population resulting in a encouraging result, but published clinical data on optimal patient position for ultrasound-guided LPB are limited. We designed this prospective randomized study to compare the success rate, time of performance and complications of ultrasound guided posterior lumbar plexus block as well as subgluteal or sub-greater trochanter sciatic nerve block under lateral decubitus position v.s. prone position.
Investigators
Eligibility Criteria
Inclusion Criteria
- •18 to 75 years old
- •elective unilateral lower limb surgery
- •ASA Physical Status ASA I-III
Exclusion Criteria
- •age \<18 or \>75 year old
- •ASA Physical Status \>ASA III
- •abnormal blood coagulation
- •infection near puncture place
- •nerve injury
- •bilateral lower limb surgery
- •patients with lumbar vertebral trauma
- •inability to be properly positioned
- •chronic narcotic therapy or illicit drug use
Outcomes
Primary Outcomes
Block success defined as loss of sensation to pinprick in each of the lumbar plexus and sciatic nerve distributions when measured 30 min after block performance.
Time Frame: 30min
Motor blockade was evaluated by assessing the strength of knee extension (femoral nerve), thigh adduction (obturator nerve), and plantar flexion and dorsiflexion of the ankle (sciatic nerve) 30 min after block performance.
Time Frame: 30min
Secondary Outcomes
- block execution time, depth of the nerve, needle depth, duration of the sensory and motor blockade, complications such as inadvertent needle puncture of epidural space, dural puncture, peritoneal puncture, and kidney or ureter puncture and nerve injury.(within 48h)