The Musculocutaneous Nerve in a High Resolution MRI

NCT02305875 | Completed

• 1 other identifier: S-04115B
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators have made a favourable experience with the in 2006 published transarterial triple injection method \[4\]. This classic method combines the block effect of an axillary catheter injection (median nerve position) with a double transarterial injection at terminal nerve level in the axilla. The investigators experience after a recent published MRI study \[3\], confirms that a proximal axillary local anesthetic injection via an axillary catheter, guided by nerve stimulator, is beneficial for the block effect. The MRI study was conducted using nerve stimulation and a transarterial technique. The proximal injection with an effect at cord level, combined with axillary injections at terminal nerve level, produce an effective block distal to the elbow. The proximal injection has obviously an effect to the lateral cord and the musculocutaneous nerve (mcn) \[3\]. Recent studies have advocated that a double axillary injection method is sufficient for the axillary block \[5, 6\]. Their block techniques included a selective block of the mcn at terminal nerve level. The investigators MRI study \[3\] demonstrated a successful block effect (analgesia or anaesthesia) of the mcn nerve in all patients (15 of 15 patients) in the triple injection group without a selective block of this nerve. In the 1- deposit (catheter injection) and 2-deposit (transarterial injections) group, 11 of 15 patients (73%) had the mcn successful blocked. The objective in this study (Article 4) is to examine the mean position of the mcn nerve and its relationship to the coracobrachial muscle. Can MRI indicate / predict that a proximal directed axillary catheter in median nerve position is beneficial in order to provide a successful mcn blockade? Is a selective injection to the mcn at terminal nerve level superfluous when a catheter is used?

Conditions

Brachial Plexus Block

Outcome Measures

Primary Outcomes (1)

• Position of the musculocutaneous nerve in the axillary sheat. Mean distance in cm to the humeral head and the insertion point of the catheter in 54 patients.

  6 months

Study Arms (1)

MCN scoring

EXPERIMENTAL

Scoring of the mcn nerve's position in the axillary sheat using MRI

Other: MCN scoring

Interventions

MCN scoring OTHER

Mcn's distance from top of the humeral head. Mcn's distance to the catheters insertion point. Mcn's distance and position in relationship to the axillary artery.

MCN scoring

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled for hand surgery
• ASA 1 - 2
• Weight from 50 - 95 kg
• MR compatible, suitable

You may not qualify if:

• Neurologic deficit
• Reaction to LA

Sponsors & Collaborators

• Diakonhjemmet Hospital: lead

Study Sites (1)

The Intervention Centre, Rikshospitalet, Oslo University Hospital

Oslo, 0027, Norway

Location

Study Officials

• Per Kr Hol, PhD

  University of Oslo, The Intervention Centre

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Section manager

Study Record Dates

• First Submitted: November 19, 2014
• First Posted: December 3, 2014
• Study Start: October 1, 2014
• Primary Completion: April 1, 2015
• Study Completion: May 1, 2015
• Last Updated: May 18, 2015

Record last verified: 2015-05

Locations

NO (1)