Diaphragmatic Dysfunction After Ultrasound-guided Supraclavicular Brachial Plexus Block With the Double Injection Technique
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 35
- 试验地点
- 2
- 主要终点
- Frequency of hemi-diaphragmatic paresis
研究概览
简要总结
The investigators plan to determine the onset time and incidence of hemidiaphragmatic paresis (HDP) with a double injection supraclavicular nerve block in patients presenting for upper extremity surgery below the elbow.
The hypothesis is HDP following supraclavicular brachial plexus block occurs with-in 15 minutes of block performance and is not associated with subjective dyspnea.
详细描述
This study will be an observational trial to assess the onset time and incidence of hemidiaphragmatic paresis in patients who undergo the double injection ultrasound-guided supraclavicular block. Diaphragmatic dysfunction will be determined by intercostal diaphragm thickening measured using ultrasound. The available image will be saved.
Patients having below the elbow surgery will be be approached by someone from the research team for consent and possible inclusion in the study. This will be done in the anesthesia preoperative assessment clinic, or in the pre-op area on the day of surgery (if a patient was not seen in clinic).
A baseline ultrasonographic diaphragmatic assessment will be completed. Study participants will then receive supraclavicular brachial plexus block as per standard of care. Ultrasonographic diaphragmatic assessment and dyspnea score (using modified Borg dyspnea scale) will be performed every 5 minutes for 30 minutes, or until the patient is transferred to the operating room, whatever comes first. Patients will also undergo an ultrasonographic diaphragmatic assessment and dyspnea score in the recovery room after their surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients presenting for unilateral upper extremity surgery below the level of the elbow (the forearm or hand) who are having a double injection regional block for anesthesia
- •18 years old and over
- •Weight 50kg or greater
- •English speaking
- •American Society of Anesthesiologists physical status 1-3
排除标准
- •Known Chronic Obstructive Pulmonary Disease
- •Pregnancy
- •Any significant neurologic dysfunction, or inability to visualize the diaphragm during baseline sonographic assessment
结局指标
主要结局
Frequency of hemi-diaphragmatic paresis
时间窗: Relative change in ultrasound assessment of diaphragmatic thickening (Baseline vs 30 min after supraclavicular block)
Number of participants in which hemi-diaphragmatic paresis is detected using ultrasound measurement of diaphragmatic thickening
Onset time of hemi-diaphragmatic paresis
时间窗: Baseline, 5, 10, 15, 20, 25, and 30 minutes after block
The average time at which hemi-diaphragmatic paresis is detected using ultrasound measurement of diaphragmatic thickening
次要结局
- The correlation of subjective dyspnea(Baseline, 5, 10, 15, 20, 25, and 30 minutes after block)
- Incidence of HDP after surgical procedure under supraclavicular brachial plexus block (in post recovery unit).(Post-operatively up to 24 hours)
研究者
Vishal Uppal
Principal Investigator
Nova Scotia Health Authority