Needle Nerve Contact in Ultrasound Guided Femoral Block
Study Details
Study Description
Brief Summary
Ultrasound-guided femoral nerve block is a common regional anesthesia technique. The optimal method of needle guidance (in-plane versus out-of-plane) with regards to the block efficacy and avoidance of needle-nerve contact has not been established. In this study the investigators tests the hypothesis that the incidence of needle-nerve contact is higher with the needle insertion in an out-of-plane than with the in-plane approach.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Fourty-four patients with hip fracture (American Society of Anesthesiologists physical status 1-3) are being randomized to receive the femoral block with an out-of-plane (needle inserted at a 45°-60° angle 1 cm caudal to the midpoint of the ultrasound probe just above the femoral nerve) or an in-plane technique (needle inserted 0.5 cm from the side of the probe lateral to the femoral nerve). The data collected includes the depth of needle insertion at the endpoint before injection, response to nerve stimulation, distribution of the injected volume in relation to the nerve (anterior vs posterior, the latter indicating impalement), block efficacy at 20 minutes and 24 hours, and any signs of nerve injury).
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: in plane needle placement
|
Procedure: Needle placement
In plane versus out of plane needle placement techniques
|
| Experimental: out of plane needle placement
|
Procedure: Needle placement
In plane versus out of plane needle placement techniques
|
Outcome Measures
Primary Outcome Measures
- Number of intraneural needle insertion in ultrasound-guided femoral block: out-of-plane versus in-plane approach [4 months]
The incidence of needle-nerve contact is higher with the out-of-plane approach (inserting the needle into the fascia at the midpoint over the femoral nerve)needle-nerve contact than with the in-plane approach (inserting the needle lateral to the femoral nerve).
Secondary Outcome Measures
- Number of Participants with femoral block success in ultrasound-guided femoral block: out-of-plane versus in-plane approach. [4 months]
The efficacy of the out-of-plane approach (inserting the needle into the fascia at the midpoint over the femoral nerve)needle-nerve contact and the in-plane approach (inserting the needle lateral to the femoral nerve).
Eligibility Criteria
Criteria
Inclusion Criteria:
-
ASA physical status 1-3 patients
-
Diagnosis of trochanteric or cervical hip fracture
-
Hip replacement under spinal anesthesia
Exclusion Criteria:
- Patients under the age of 65 years or over the age of 90 years
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | St Luke'S Roosevelt Hospital, Columbia University | New York | New York | United States | 10025 |
| 2 | University of Barcelona | Barcelona | Spain |
Sponsors and Collaborators
- Hospital Clinic of Barcelona
Investigators
- Principal Investigator: Xavier Sala-Blanch, MD, University Clinic Barcelona
- Principal Investigator: Ana Ruiz, MD, University of Barcelona
- Study Chair: Julia Martinez-Ocon, MD, University of Barcelona
- Study Chair: Maria J Carretero, MD, University of Barcelona
- Study Chair: Gerard Sánchez-Etayo, MD, University of Barcelona
- Study Director: Admir Hadzic, Prof Dr, Columbia University St Luke's Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- R6345