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Minimum Effective Volume of 0.375% Bupivacaine in Interscalene Brachial Plexus Block

Phase 2
Conditions
Shoulder Surgery
Interventions
Registration Number
NCT01667315
Lead Sponsor
Federal University of São Paulo
Brief Summary

The use of ultrasound in regional anesthesia enables reduction in the local anesthetic volume. The present study aimed to determine the minimum effective volume of 0.375% bupivacaine with epinephrine for interscalene brachial plexus block for shoulder surgery. Following approval by the Research Ethics Committee, patients with a physical condition of I or II according to the American Society of Anesthesiologists, between 21 and 65 years old and subjected to elective surgery of the shoulder and interscalene brachial plexus block will be recruited. The volume of the anesthetic will be determined using a step-up/step-down method and based on the outcome of the preceding block. Positive or negative block results in a 1mL reduction or increase in volume, respectively. The success of the block is defined as the presence of motor block in two muscle groups and the absence of thermal and pain sensations in the necessary dermatomes within 30 minutes of the injection. Diaphragmatic paralysis, pulmonary function and analgesia will be quantified at 30 minutes, 4 and 6 hours. Data will undergo statistical analysis in order to determine minimum effective volume of 0.375% bupivacaine and, secondarily, the maximum volume that maintains the diaphragmatic function, evaluate diaphragm paralysis and its influence in pulmonary function.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
33
Inclusion Criteria
  • Age between 21 and 65 years
  • Candidates for an elective surgical intervention on the shoulder with indication for anesthesia via brachial plexus block
  • Physical condition of I or II according to the American Society of Anesthesiologists
  • Body mass index up to 35 kg.m-2
Exclusion Criteria
  • Chronic obstructive pulmonary disease
  • Cognitive impairment or active psychiatric condition
  • Infection at the site of the puncture for the block
  • Coagulopathy
  • Bupivacaine allergy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
BupivacaineBupivacaine 0,375%Bupivacaine 0,375%
Primary Outcome Measures
NameTimeMethod
Minimum effective volume of 0,375% bupivacaine30 minutes

Minimum effective volume of 0,375% bupivacaine with epinephrine in ultrasound-guided interscalene brachial plexus block for shoulder surgery

Secondary Outcome Measures
NameTimeMethod
Maximum 0,375% bupivacaine volume that maintains the diaphragmatic functionBefore block, 10, 20 and 30 minutes, 4 and 6 hours after

Maximum effective volume of 0,375% bupivacaine with epinephrine in ultrasound-guided interscalene brachial plexus block for shoulder surgery without diaphragmatic block

Pulmonary functionBefore block, 30 minutes, 4 and 6 hours after

Spirometric evaluation of forced vital capacity

Diaphragmatic FunctionBefore block, 30 minutes, 4 and 6 hours after

Diaphragmatic movement on ultrasound

Trial Locations

Locations (1)

Federal University of Sao Paulo

🇧🇷

Sao Paulo, Brazil

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