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Plasma Concentration of Lidocaine and Bupivacaine Axillary BPB Mixture Solutions [PCLBAxMix]

Not Applicable
Conditions
Arm Injury
Interventions
Registration Number
NCT03527836
Lead Sponsor
University of Pecs
Brief Summary

The doses of local anesthetics can be decreased with the use of ultrasound guidance. In case of using mixture solutions the benefits and drawbacks are controversial. The plasma concentrations were not studied up to this time in this kind of settings, so investigators believe that this is the first work that shows how lidocaine change the plasma concentration of bupivacaine after axillary approach to brachial plexus employed with different dilute and mixed solutions for upper limb surgery in trauma patients.

Detailed Description

Total of 30 American Society of Anesthesiologist (ASA) I-III adult patients scheduled to elective or emergency trauma surgery of hand and forearm under ultrasound-guided (UG) brachial plexus block (BPB) are planned to be assigned into this randomized-prospective observational study after approval by the University Research Ethics Board, Pécs University Medical School, Hungary. All of the patients will receive detailed information about the planned BPB techniques and surgeries, then written informed consents will be obtained.

Study participants are planned to be assigned randomly by the research coordinator into 3 groups (Lidocaine, Bupivacaine and mixture solution) according to the concentration of lidocaine and bupivacaine in the mixture solution.

Standardized UG Axillary-supraclavicular (AX-SC) approach to the BP is planned to be performed under sterile conditions by the same anesthesiologist. The standardized dose is 0.4 ml/kg with the targeted maximized the single-shot volume of 30 ml.

Blood samples will be taken at 0-time point (straight after the administration of BP injection) and 30, 60, 240 and 480 minutes after. Plasma concentrations are determined, the results are collected and analyzed.

Under standard monitorization, vital parameters, data are collected on the onset time and duration of actions of local anesthetics (LAs).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • unpremedicated patient scheduled for elective or emergency trauma surgery of hand and forearm under ultrasound-guided BPB
Exclusion Criteria
  • continuous peripheral nerve catheter technique or bilateral block was planned, or the patient refused to participate. Exclusion criteria included psycho-mental conditions interfering with consent or assessment; pre-existing chronic pain condition or daily analgesic or sedative consumption; sedative or analgesic premedication; pre-existing neurological disorders affecting the brachial plexus.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
LidocaineLidocaine brachial plexus blockLidocaine brachial plexus block 0.4 ml/kg of 0.66% solution
MixtureMixture brachial plexus blockMixture brachial plexus block 0.4 ml/kg of 0.33% bupivacaine and 0.33% lidocaine solution
BupivacaineBupivacaine brachial plexus blockBupivacaine brachial plexus block 0.4 ml/kg of 0.33% solution
Primary Outcome Measures
NameTimeMethod
Maximal plasma concentrations0-8 hours

Plasma concentrations of bupivacaine and lidocaine 0-8 hours after injection

Secondary Outcome Measures
NameTimeMethod
Duration1-24 hours

Duration of actions of local anesthetics

Onset times0-0.5 hours

Onset times of local anesthetics

Trial Locations

Locations (1)

University of Pécs, Medical School

🇭🇺

Pécs, Baranya, Hungary

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