Regional Changes in Upper Limb Perfusion Following Brachial Plexus Block: A Pilot Study

NCT02589054 | Completed

• 1 other identifier: 106285
• Study Type: observational
• Target: 18
• Locations: 0 countries
• Sites: N/A

Brief Summary

Ultrasound-guided regional anesthesia is increasingly being used in the modern surgical environment to provide specific intraoperative anesthesia and postoperative analgesia. Infiltration of local anesthesics around peripheral nerves firs blocks sympathetic, then sensory, then motor nerve function. Sympathectomy-induced vasodilation following brachial plexus block results in increased skin temperature and arterial flow within minutes. Although it has not been shown to reliably increase diameter or cross-sectional area of distal arteries, brachial plexus block does change the pattern and quantity of blood flow to the hand. Given that the magnitude of change of flow cannot be attributed to vessel radius, the investigators suspect that the more laminar fluid dynamics are due to vascular tone. The investigators study aims to quantify alterations in physiology and peripheral vasodilator response. The investigators anticipate that axially block will significantly improve regional blood flow.

Conditions

Anesthesia, Conduction; Nerve Block; Sympathectomy; Regional Blood Flow

Outcome Measures

Primary Outcomes (1)

• Changes in regional blood flow and perfusion characteristics in the upper arm arteries from baseline to 20 minutes after unilateral axillary block.

  Physiologic parameter

  30 minutes

Secondary Outcomes (4)

• Changes in the caliber of the arteries of the arm between arms from baseline to 20 minutes after unilateral axillary block.

  30 minutes

• Changes in skin temperature between hands from baseline to 20 minutes after unilateral axillary block.

  30 minutes

• Sensory loss in radial, ulnar, and median nerve distribution between hands from baseline to 20 minutes after unilateral axillary block.

  30 minutes

• Motor weakness in radial, ulnar, and median nerve distributions between hands from baseline to 20 minutes after unilateral axillary block

  30 Minutes

Study Arms (1)

Patients

Other: Monitoring

Interventions

Monitoring OTHER

Patients

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Individuals coming for elective upper extremity surgery who would already be having a brachial plexus block for their anesthesia.

You may qualify if:

• ASA physical status I, II, III
• BMI less than or equal to 39
• Presenting for elective upper limb surgery

You may not qualify if:

• Age over 80
• ASA physical status IV or V
• BMI greater or equal to 40
• Language barrier precluding ability to give informed consent
• History of coagulopathy
• INR \< 1.4
• Platelet count \< 100
• Allergy to local anesthetics
• Known peripheral vascular disease of the upper limbs
• Amputation of one or both upper limbs, not including digits
• Peripheral neurological disease
• Does not consent to participate in study

Sponsors & Collaborators

• London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's: lead
• University of Western Ontario, Canada: collaborator
• London Health Sciences Centre: collaborator
• St. Joseph's Health Care London: collaborator

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 22, 2015
• First Posted: October 28, 2015
• Study Start: November 1, 2015
• Primary Completion: January 1, 2016
• Study Completion: March 1, 2016
• Last Updated: March 30, 2017

Record last verified: 2015-10