Comparison of Two Position for Ultrasound Guided Lumbar Plexus and Sciatic Nerve Block

Comparison of Lateral Decubitus Position Versus Prone Position for Ultrasound Guided Posterior Lumbar Plexus Block and Sciatic Nerve Block

In the present study, the investigators will test the effect of two position on posterior lumbar plexus and subgluteal or sub-greater trochanter sciatic nerve block.

Study Overview

• Status: Completed
• Conditions: Lower Limb Surgery
• Intervention / Treatment: Procedure: SGPP; Procedure: SGTPP; Procedure: SGLP; Procedure: SGTLP

Detailed Description

The posterior lumbar plexus block approach was described approximately 30 years ago, using surface anatomical landmarks and a loss-of-resistance technique, but over the years it was almost abandoned for its low successful rate, the huge numbers of adverse effects and its difficulties to be performed. The introduction of the nerve stimulator and ultrasound guided technique in recent years increased the success rate in various peripheral nerve blocks and decreased adverse effects. Ultrasound guided LPB as well as sciatic nerve block technique in a small patient population resulting in a encouraging result, but published clinical data on optimal patient position for ultrasound-guided LPB are limited. We designed this prospective randomized study to compare the success rate, time of performance and complications of ultrasound guided posterior lumbar plexus block as well as subgluteal or sub-greater trochanter sciatic nerve block under lateral decubitus position v.s. prone position.

• Study Type: Interventional
• Enrollment (Anticipated): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hubei
    • Wuhan, Hubei, China, 430030
      • Department of Anaesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 71 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18 to 75 years old
• elective unilateral lower limb surgery
• ASA Physical Status ASA I-III

Exclusion Criteria:

• age <18 or >75 year old
• ASA Physical Status >ASA III
• abnormal blood coagulation
• infection near puncture place
• nerve injury
• bilateral lower limb surgery
• patients with lumbar vertebral trauma
• inability to be properly positioned
• chronic narcotic therapy or illicit drug use

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SGPP; ultrasound guided posterior lumbar plexus block and subgluteal sciatic nerve block under prone position	Procedure: SGPP; ultrasound guided posterior lumbar plexus block and subgluteal sciatic nerve block under prone position
Experimental: SGTPP; ultrasound guided posterior lumbar plexus block and sub-greater trochanter approach under prone position	Procedure: SGTPP; ultrasound guided posterior lumbar plexus block and sub-greater trochanter approach under prone position
Experimental: SGLP; ultrasound guided posterior lumbar plexus block and subgluteal sciatic nerve block under lateral decubitus position	Procedure: SGLP; ultrasound guided posterior lumbar plexus block and subgluteal sciatic nerve block under lateral decubitus position
Experimental: SGTLP; ultrasound guided posterior lumbar plexus block and sub-greater trochanter approach under lateral decubitus position	Procedure: SGTLP; ultrasound guided posterior lumbar plexus block and sub-greater trochanter approach under lateral decubitus position

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Block success defined as loss of sensation to pinprick in each of the lumbar plexus and sciatic nerve distributions when measured 30 min after block performance.	30min
Motor blockade was evaluated by assessing the strength of knee extension (femoral nerve), thigh adduction (obturator nerve), and plantar flexion and dorsiflexion of the ankle (sciatic nerve) 30 min after block performance.	30min

Secondary Outcome Measures

Outcome Measure	Time Frame
block execution time, depth of the nerve, needle depth, duration of the sensory and motor blockade, complications such as inadvertent needle puncture of epidural space, dural puncture, peritoneal puncture, and kidney or ureter puncture and nerve injury.	within 48h

Collaborators and Investigators

• Sponsor: Huazhong University of Science and Technology

Study record dates

Study Major Dates

• Study Start: April 1, 2009
• Primary Completion (Actual): December 1, 2010
• Study Completion (Actual): December 1, 2010

Study Registration Dates

• First Submitted: October 1, 2009
• First Submitted That Met QC Criteria: October 1, 2009
• First Posted (Estimate): October 2, 2009

Study Record Updates

• Last Update Posted (Estimate): February 17, 2011
• Last Update Submitted That Met QC Criteria: February 16, 2011
• Last Verified: February 1, 2011

More Information

Terms related to this study

• Keywords: position; ultrasound guidance; sciatic nerve block; Lumbar plexus block; elective lower limb surgery
• Other Study ID Numbers: TJHMZK01001