Changes in Pulse Wave Transit Time and Its Variability After Placement of Interscalene Brachial Plexus Block

Completed

• Conditions: Interscalene Brachial Plexus Block
• Interventions: Procedure: Interscalene brachial plexus block

• Registration Number: NCT05944497
• Lead Sponsor: JongHae Kim

Brief Summary

Pulse wave transit time (PWTT) increases due to decreased arterial vascular tone resulting from sympathetic blockade caused by regional anesthesia. Its oscillation (PWTT variability) also contains information on the interaction between autonomic nervous system and the cardiovascular system. The changes in PWTT and its variability have not been investigated in patients receiving interscalene brachial plexus block (ISBPB). It was hypothesized that ISBPB increases PWTT and reduces low frequency power of PWTT variability.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-06-28
• Study First Submitted QC: 2023-07-11
• Study First Posted: 2023-07-13
• Study Start: 2023-07-31
• Status Verified: 2024-01
• Primary Completion: 2024-01-07
• Study Completion: 2024-01-07
• Last Update Submitted: 2024-01-22
• Last Update Posted: 2024-01-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 59

Inclusion Criteria

• American Society of Anesthesiologists status of 1
• Scheduled to receive interscalene brachial plexus block for arthroscopic shoulder surgery

Exclusion Criteria

• Coagulopathy
• Infection of the skin area for interscalene brachial plexus block
• Peripheral neuropathy or neurologic sequelae in the upper limb ipsilateral to the surgery
• Allergy to local anesthetics or a history of allergic shock
• Contralateral vocal cord palsy, hemidiaphragmatic paresis/paralysis or pneumo/hemo thorax
• Arrhythmias
• Cardiac conduction abnormalities
• A history of medication affecting cardiac conduction
• Ischemic heart disease
• Hypertension
• Diabetes mellitus
• Thyroid disfunction
• Other medical conditions affecting autonomic nervous activity

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
ISBPB group	Interscalene brachial plexus block	Interscalene brachial plexus block involving the C5 to C8 nerve roots

Primary Outcome Measures

Name	Time	Method
Natural-log-transformed low frequency power of pulse wave transit time variability	Between 15 and 20 minutes after block needle insertion	Calculated by integrating the power spectra of pulse wave transit time variability between 0.04 and 0.15 Hz.

Secondary Outcome Measures

Name	Time	Method
Sensory blockade	20 minutes after block needle insertion	Assessed by grading the coldness with a 3-level scale consisting of 0 (no cold sensation), 1 (reduced cold sensation), and 2 (normal cold sensation) after applying an alcohol swab to the upper limb dermatomal areas innervated by the C5 to T1 nerve roots.
Natural-log-transformed low frequency power of pulse wave transit time variability	Between 5 and 10 minutes after block needle insertion	Calculated by integrating the power spectra of pulse wave transit time variability between 0.04 and 0.15 Hz.
Natural-log-transformed high frequency power of pulse wave transit time variability	Between 15 and 20 minutes after block needle insertion	Calculated by integrating the power spectra of pulse wave transit time variability between 0.15 and 0.4 Hz.
Pulse wave transit time	Between 15 and 20 minutes after block needle insertion	Time difference in milliseconds between the R peak of the electrocardiographic waveform and the peak of the 2nd-derivative photoplethysmographic waveform.
Bilateral pupil diameters	20 minutes after block needle insertion	Measured using a portable automated monocular infrared pupillometer (PLR-3000, NeurOptics Inc., Irvine, CA, the United States) at 30 Hz for 2 seconds.
Incidence of side effects related to interscalene brachial plexus block	20 minutes after block needle insertion	Horner's syndrome, subjective dyspnea, and hoarseness
Motor blockade	20 minutes after block needle insertion	The muscle contraction power is rated as 0 (complete block), 1 (partial block), and 2 (no block) for shoulder abduction (axillary nerve), elbow flexion (musculocutaneous nerve), forearm supination (radial nerve), forearm pronation (median nerve), wrist extension (radial nerve), wrist flexion (median nerve), finger abduction (ulnar nerve), thumb abduction (radial nerve), thumb adduction (ulnar nerve), and thumb opposition (median nerve).

Trial Locations

Locations (1)

Daegu Catholic University Medical Center; 🇰🇷 Daegu, Korea, Republic of