- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02305875
The Musculocutaneous Nerve in a High Resolution MRI
The Musculocutaneous Nerve (Mcn) in a High Resolution MRI
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?
Study Overview
Detailed Description
45 patients were examined with MRI in a previous study [3] and now they underwent an additionally examination with a special focus on the anatomy and course of the mcn nerve. A line was drawn from the most cranial part of the humeral head perpendicular towards the brachial plexus. The distance from this line to the point where the mcn nerve entered the coracobrachial muscle was measured. This entering point was defined as the point where the mcn nerve left the axillary sheat. The visulaity of the mcn was scored as 0 = not visible, 1 = partly visible and 2 = clear visible.
The evaluation was a consensus assessment where all authors evaluated the T2-weighted, fat suppressed MRI images at the same time. If the mcn nerve could not be identified, the patients were excluded.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Oslo, Norway, 0027
- The Intervention Centre, Rikshospitalet, Oslo University Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients scheduled for hand surgery
- ASA 1 - 2
- Weight from 50 - 95 kg
- MR compatible, suitable
Exclusion Criteria:
- Neurologic deficit
- Reaction to LA
Study Plan
How is the study designed?
Design Details
- Primary Purpose: BASIC_SCIENCE
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: MCN scoring
Scoring of the mcn nerve's position in the axillary sheat using MRI
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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.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
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.
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Per Kr Hol, PhD, University of Oslo, The Intervention Centre
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- S-04115B
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