The Anterior Approach of the Combined Lumbar and Sacral Plexuses Block for Analgesia of Lower Limb Surgeries
- Conditions
- Lower Limb Fracture
- Interventions
- Procedure: one point combined Lumbar and sacral plexus block
- Registration Number
- NCT06019754
- Lead Sponsor
- Zagazig University
- Brief Summary
lumbosacral plexus block (LSPB) has been widely applied in orthopedics departments due to its advantages, including reduction in the application of opiates, decreasing the occurrence of acute pain, promoting early activation, and shortening the time of hospital stay. LSPB is a peripheral regional technique of anesthesia and analgesia, that provides a block of the main components of the lumbosacral plexus.
- Detailed Description
Traditional ultrasound-guided lumbar plexus block combined with sacral plexus block requires separate blocks at different sites, requiring the lateral decubitus or prone position, which may be suboptimal in patients with severe pain. we present an anterior approach for combined lumbar and sacral plexus blocks with a one-point puncture.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 56
- ASA I-II.
- patients diagnosed with unilateral lower limb fracture who necessitate intraoperative tourniquet application
- patients who have severe pain hindering changing their position or patients who have spinal fractures or refusing spinal anesthesia.
- Ideal body weight > 60 kg
- patients with the capability of communication
- puncture site infection
- patients with coagulation disorders
- patients who refuse to participate or withdraw due to personal reasons
- allergy to local anesthetics.
- past surgery at the site of the block
- hip ankylosis
- drug abuse
- Body mass index ≥ 35 kg/m2
- peripheral vascular insufficiency
- use of alpha or beta blocker agents
- Nerve injury of the affected lower limb
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control group one point combined Lumbar and sacral plexus block patients who will be recruited in the control group will receive general anesthesia only Interventional group one point combined Lumbar and sacral plexus block Patients who will be recruited in the Interventional will receive one point combined lumbar and sacral plexus block. then they will receive general anesthesia
- Primary Outcome Measures
Name Time Method Total intraoperative and postoperative opioid consumption Total fentanyl used intraoperative and total morphine consumed up to 24 hours postoperative The total fentanyl doses consumed in the entire operative procedure and morphine consumed for 24 hours postoperative will be calculated.
- Secondary Outcome Measures
Name Time Method (NRS) score assessment pre-block, 30 min post-block , and postoperatively in the recovery room, and then it will be repeated 3 h, 6h, 12h, and 24, hours preoperative and postoperatively pain (NRS) score assessment for 24 hours Numerical Pain Score (NRS) ranges from 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable. Adequate pain control will be considered at Numerical Pain Score (NRS) \< 4.
Pain will be assessed using (the NRS) score preoperatively before the block and 30 min post-block, then postoperatively in the recovery room, 3 h, 6h, 12h, and 24 hours.Block success assessment using perfusion index (PI) before and after performing the block Recording Perfusion index readings at baseline and 10, 20, 30 min. post block Perfusion index (PI) values rise with successful peripheral nerve blocks. If PI is not changed, this means block failure
Trial Locations
- Locations (1)
Faculty of Medicine - Zagazig University
🇪🇬Zagazig, Egypt