How Do We Ultrasound-Guided Popliteal Approach Sciatic Nerve Block?
- Conditions
- AdultAnesthesia Injection SiteRegional Anesthesia Morbidity
- Interventions
- Other: Subparaneural Injection (Grup S), BlockOther: Interneural Injection (Grup I), Block
- Registration Number
- NCT06372691
- Lead Sponsor
- Ankara City Hospital Bilkent
- Brief Summary
The aim of this prospective, randomized, observer-blind study to compare subparaneural approach injection with interneural approach injection in popliteal sciatic nerve blocks.
- Detailed Description
The study will involve American Society of Anesthesiologists Physical Status Classification (ASA) III or IV risk group patients, 18 years of age or older, who will undergoing foot, ankle, or toe amputation.
Supparaneural injection (Group S) and interneural injection method (Group I) will the two research groups to which patients were randomly allocated.
Every 5 minutes following LA injection, an investigator who will blind to randomization will assess the sensory and motor blockage in the operated foot. The study will documented the operative time, block characteristics, such as the duration of block administration, sensory and motor block start and regression times, the time of extra analgesic required, and the occurrence of complications.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 809
- 18 years and over
- Planned foot, ankle or toe amputation
- ASA III-IV risk group
- Patients who agreed to be included in the study
- People with neurological and psychiatric diseases
- Using opioids or another analgesic for chronic pain
- Allergic to local anesthetics
- Pregnant or breastfeeding
- Those with infection or sepsis in the application area
- Patients who did not agree to be included in the study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Subparaneural Injection (Group S) Subparaneural Injection (Grup S), Block The position of the patients will be prone.The skin will be cleaned according to asepsis and antisepsis rules.After preparing the USG a high-frequency linear array transducer under sterile conditions,we will be positioned it transversely in the popliteal fossa.After visualizing the artery,its hyperechoic nerves will be founded superficially.The sciatic nerve will be identified proximally to visualize where the TN and CPN eventually come together to form the sciatic nerve and separate distally where the CPN moves laterally and the TN remains medially.Once the nerves began to separate,they will be scanned until a figure 8 or pant leg image will be obtained.Using the in-plane technique under ultrasonography guidance, injection will be applied to the subparaneural area in Group S.1 ml of LA solution was injected for the purpose of verifying proper needle insertion.A standard dose of 15 mL bupivacaine 0.5% and 5mg/mL local anesthetic was used accompanied by a 20G,12mm block needle. Interneural Injection (Group I) Interneural Injection (Grup I), Block The position of the patients will be prone.The skin will be cleaned according to asepsis and antisepsis rules.After preparing the USG a high-frequency linear array transducer under sterile conditions, we will be positioned it transversely in the popliteal fossa.After visualizing the artery, its hyperechoic nerves will be founded superficially.The sciatic nerve will be identified proximally to visualize where the TN and CPN eventually come together to form the sciatic nerve and separate distally where the CPN moves laterally and the TN remains medially.Once the nerves began to separate, they will be scanned until a figure 8 or pant leg image will be obtained.Using the in-plane technique under ultrasonography guidance, injection will be applied to the interneural area in Group I.1 ml of LA solution was injected for the purpose of verifying proper needle insertion.A standard dose of 15 mL bupivacaine 0.5% and 5mg/mL local anesthetic was used accompanied by a 20 G, 12mm block needle.
- Primary Outcome Measures
Name Time Method Onset Time Time from the moment the block is made to the moment it starts, within the first half hour Onset time will be defined as the moment when it is determined that the block is successful.
- Secondary Outcome Measures
Name Time Method Block Execution Times 1-10 minutes The time from the moment the block starts to the moment the transaction ends.
Hemodynamic Effects Of The Block 0th minutes, 5th minutes,10th minutes,15th minutes,20th minutes,25th minutes,30th minutes,35th minutes,40th minutes,45th minutes,50th minutes,55th minutes and 60th minutes and then at 1-hour intervals and 15th minutes,30th minutes Noninvasive systolic and diastolic blood pressure
Regression Time Of Sensory and Motor Block Within 24 hours When the block starts to come back.
Total Block Times Within 24 hours How long the block took in total.
Adverse Effects to Anesthesia During the block period, within 24 hours hypotension, agitation, nausea, vomiting, dizziness
Effects Of The Block On Heart Rate 0th minutes, 5th minutes,10th minutes,15th minutes,20th minutes,25th minutes,30th minutes,35th minutes,40th minutes,45th minutes,50th minutes,55th minutes and 60th minutes and then at 1-hour intervals and 15th minutes,30th minutes Heart rate
Effects Of The Block On Peripheral Pulse Oximetry 0th minutes, 5th minutes,10th minutes,15th minutes,20th minutes,25th minutes,30th minutes,35th minutes,40th minutes,45th minutes,50th minutes,55th minutes and 60th minutes and then at 1-hour intervals and 15th minutes,30th minutes Peripheral pulse oximetry
Need for Multiple Injections Owing to Insufficient Anesthesia Within 24 hours How many blocks should be made.
Additional Rescue Analgesic Within 24 hours Analgesic use status.
Trial Locations
- Locations (1)
Ankara Bilkent City Hospital
🇹🇷Ankara, Çankaya, Turkey