Looking for Minimum Dose to Induce Sympathectomy in Infraclavicular Brachial Plexus Block

• Conditions: Finding the Minimum Dose to Induce Sympathectomy in Infraclavicular

• Registration Number: NCT04417608
• Lead Sponsor: Taipei Medical University WanFang Hospital

Brief Summary

For patients who undergoing hemodialysis, it is important to have good AV fistula. One third of AV fistula usually fail during early stage. It is helpful to use nerve block to dilate the blood vessels and enhance the prognosis. But 0.2% Ropivacaine usually cause muscle weakness in present studies. The investigators hope to find the lowest concentration to provide sympathectomy without muscle weakness. Because the patients with hemodialysis usually have multiple co-morbidity, thus we choose patients with forearm fracture at the first place. With this result, the investigators can design further study for patients with hemodialysis. The investigators prefer proximal approach because brachial plexus run together in the cosctoclavicular space and show lower incidence of incomplete work.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-05-31
• Status Verified: 2020-06
• Study First Submitted QC: 2020-06-03
• Last Update Submitted: 2020-06-03
• Study Start: 2020-06-04
• Study First Posted: 2020-06-04
• Last Update Posted: 2020-06-04
• Primary Completion: 2021-07-04
• Study Completion: 2021-07-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 66

Inclusion Criteria

• Age between 20-80 y/o, BW: 40-90 kilograms，ASA class I-III，No pre-existing neuropathy，Scheduled for upper limb surgery.

Exclusion Criteria

1. Pre-existing neuropathy (ex: polyneuropathy)
2. History of allergy to xylocaine、ropivacaine、epinephrine
3. Emergent surgery
4. Coagulopathy
5. Patient who can not express themselves

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change of diameter of basilic vein and brachial artery	Change from baseline diameter(pre-nerve block) at 48hour	Use ultrasound to measure the difference of diameter at different time point.

Secondary Outcome Measures

Name	Time	Method
Motor block of upper limb	48hour post nerve block	A validated 3-point scale was used: 0 = no block (patient has normal power), 1 = patient can feel weakness with the unblocked side, and 2 = complete anesthesia.
Sensory block of upper limb	24hour post nerve block	A validated 3-point scale was used: 0 = no block (patient has normal sensation), 1 = patient can feel cold, but the sensation is reduced compared with the unblocked side, and 2 = complete anesthesia.