Evaluating the Mechanism of Changes to Inferior Vena Cava Diameter Using Point of Care Ultrasound in Patients Undergoing Interscalene Brachial Plexus Block
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 试验地点
- 1
- 主要终点
- Ipsilateral hemiparesis
研究概览
简要总结
The purpose of this study is to understand how changes to breathing patterns in the chest affect blood flow to the heart from the inferior vena cava in the abdomen. Ultrasound of the upper abdomen will be used to visualize changes in breathing patterns in the chest and blood flow in the abdomen.
详细描述
In recent practice, point-of-care ultrasound has been used to assess the size and respiratory variation of the inferior vena cava as a marker for volume status and fluid responsiveness. Little investigation has occurred regarding the mechanism of observed respiratory variation. Anesthetic plans for surgery (e.g. shoulder replacement) frequently employ interscalene injections to target and block the brachial plexus, which (on the same side) results in phrenic nerve palsy and paralysis of the diaphragm. The goal of this study is to examine the relationship between diaphragmatic function and variation in IVC diameter. Specifically, the investigators will evaluate and compare the size and variability of the inferior vena cava by point-of-care ultrasound before and after brachial plexus block.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adult (age > 18 years)
- •Scheduled to receive an interscalene block
排除标准
- •Any person with known, pre-existing phrenic nerve, diaphragmatic, or inferior vena cava anomaly.
- •Patients who cannot be successfully imaged by ultrasound or who cannot participate in spirometry will additionally be excluded.
- •Non-English speaking patients will be excluded as well as there is no research funding to translate consent forms. Given that there is no potential benefit to participation in the study, this does not exclude these individuals from any potentially beneficial therapy.
结局指标
主要结局
Ipsilateral hemiparesis
时间窗: Within 30 minutes post-block
Detectable paralysis of the ipsilateral hemidiaphragm by point of care ultrasound
IVC Collapsibility Index Change
时间窗: Within 30 minutes post-block
Measured IVC diameter and collapsibility by point of care ultrasound
次要结局
未报告次要终点
研究者
Rodney Gabriel
Principal Investigator
University of California, San Diego