A Comparison of Ultrasound and Nerve Stimulator Techniques for Nerve Localization in Regional Anesthesia

The primary objective of this study is to compare ultrasound versus nerve stimulator techniques for nerve localization when performing peripheral nerve blocks. Specifically the investigators will be performing Popliteal, Femoral, and Interscalene nerve blocks. The investigators will be looking for differences in 1) time taken to locate the target nerve and inject local anesthetic 2) time from injection of local anesthetic to adequate surgical anesthesia 3) effectiveness of block 4) incidence of vascular puncture 5) incidence of adverse events 6) patient satisfaction.

Study Overview

• Status: Withdrawn
• Conditions: Orthopedic

Detailed Description

After obtaining informed consent, subjects will be randomized to either the ultrasound or nerve stimulator groups as the method for nerve localization prior to peripheral block placement.

• Study Type: Observational

Contacts and Locations

Study Locations

• United States
  • Louisiana
    • New Orleans, Louisiana, United States, 70121
      • Ochsner Clinic Foundation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients 18 years of age or older undergoing outpatient knee arthroscopy or lower leg/foot surgery as well as shoulder arthroscopy.

Description

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) Physical status I-III
• Arthroscopic knee surgery or Lower leg/foot surgery as well as shoulder arthroscopy
• Outpatient status
• Patient preference for a regional anesthetic
• Subjects should be capable of giving informed consent

Exclusion Criteria:

• Allergy to:

  • Local anesthetics
  • Hydromorphone
  • Propofol
  • Midazolam
• Patient refusal
• Infection at the injection site
• Peripheral Neuropathy

Study Plan

How is the study designed?

Number of groups / cohorts

6

Cohorts and Interventions

Group / Cohort
Interscalene Ultrasound; Subjects having orthopedic surgery requiring an interscalene peripheral nerve block and randomized to have the ultrasound used to locate the nerve.
Interscalene Nerve Stimulator; Subjects having orthopedic surgery requiring an interscalene peripheral nerve block and randomized to have the nerve stimulator used to locate the nerve.
Popliteal Ultrasound; Subjects having orthopedic surgery requiring an popliteal peripheral nerve block and randomized to have the ultrasound used to locate the nerve.
Popliteal Nerve Stimulator; Subjects having orthopedic surgery requiring an popliteal peripheral nerve block and randomized to have the nerve stimulator used to locate the nerve.
Femoral Ultrasound; Subjects having orthopedic surgery requiring an femoral peripheral nerve block and randomized to have the ultrasound used to locate the nerve.
Femoral Nerve Stimulator; Subjects having orthopedic surgery requiring an femoral peripheral nerve block and randomized to have the nerve stimulator used to locate the nerve.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
time from injection of local anesthetic to adequate surgical anesthesia	within the first 45 minutes after injection of local anesthestic

Secondary Outcome Measures

Outcome Measure	Time Frame
effectiveness of block	within 1 hour of injection
time taken to locate the target nerve and inject local anesthetic	within 45 minutes prior to injection
incidence of vascular puncture	within 30 minutes of injection
incidence of adverse events	within 2 weeks of the day of surgery
patient satisfaction	within 2 weeks of the date of surgery

Collaborators and Investigators

• Sponsor: Ochsner Health System

Publications and helpful links

General Publications

• Domingo-Triado V, Selfa S, Martinez F, Sanchez-Contreras D, Reche M, Tecles J, Crespo MT, Palanca JM, Moro B. Ultrasound guidance for lateral midfemoral sciatic nerve block: a prospective, comparative, randomized study. Anesth Analg. 2007 May;104(5):1270-4, tables of contents. doi: 10.1213/01.ane.0000221469.24319.49.
• Marhofer P, Schrogendorfer K, Wallner T, Koinig H, Mayer N, Kapral S. Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks. Reg Anesth Pain Med. 1998 Nov-Dec;23(6):584-8. doi: 10.1016/s1098-7339(98)90086-4.

Study record dates

Study Major Dates

• Study Start: January 1, 2008
• Primary Completion (ACTUAL): October 1, 2011
• Study Completion (ACTUAL): October 1, 2011

Study Registration Dates

• First Submitted: July 21, 2010
• First Submitted That Met QC Criteria: October 14, 2010
• First Posted (ESTIMATE): October 15, 2010

Study Record Updates

• Last Update Posted (ACTUAL): April 27, 2022
• Last Update Submitted That Met QC Criteria: April 19, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: 2007.127.A (OTHER: Ochnser Clinic Foundation Institutional Review Board)