Comparison Between Two Ultrasound Technologies for Ultrasound-guided Catheter Placement in Regional Anesthesia (eZono)
A Prospective, Randomized Comparison Between Two Ultrasound Technologies for Ultrasound-guided Catheter Placement in Regional Anesthesia
The use of ultrasound imaging techniques in regional anaesthesia is rapidly becoming an area of increasing interest. It represents one of the largest changes that the field of regional anaesthesia has seen. For the first time, the operator is able to view an image of the target nerve directly, guide the needle under real-time observation, navigate away from sensitive anatomy, and monitor the spread of local anaesthetic (LA).The key to successful regional anaesthesia is deposition of LA accurately around the nerve structures.
In the past, electrical stimulation which relied on surface landmark identification, was used for this. However, landmark techniques have limitations; variations in anatomy and nerve physiology , as well as equipment accuracy have had an effect on success rates and complications.
However, alongside the enthusiasm of ultrasound guidance in regional anaesthesia, there should be a degree of informed scepticism. The widespread use of the various techniques of ultrasound-guided regional blocks without adequate training raises the danger of malpractice and subsequent impaired outcome.
Adequate education in the use of regional block techniques under ultrasound guidance is essential. Recent technical developments have achieved higher ultrasound frequencies and better image resolution, as well as better post-processing and user-friendliness.
The purpose of this study is to determine whether new technical features such as reference images, higher ultrasound frequencies, better image resolution and smaller size and weight of the ultrasound probes may improve outcome (clinical benefits) and may show an increased efficacy and safety. And if the new technology of ultrasound images improves the training quality of trainees and novices in the art of ultrasound-guided blocks.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Berlin, Allemagne, 10117
- Charité - Universitätsmedizin Berlin, Klinik für Anästhesiologie
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Berlin, Allemagne, 10117
- Department of Anesthesiology and Operative Intensive Care Medicine Campus Charité Mitte / Campus Virchow-Klinikum
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Patients at the age of 18 and above who need a regional anesthesia catheter for postoperative pain management after elective orthopedic surgery
Exclusion Criteria:
- Participation in another trial according to the German Drug Law 30 days to and during the study
- Lacking willingness to save and hand out data within the study
- Accommodation in an institution due to an official or judicial order
- (Unclear) history of alcohol or substances disabuse
- Absent knowledge of German language
- Analphabetism
- Allergy to local anesthesia or other ingredients of the intravenous solutions
- For women: Pregnancy or positive pregnancy test within the preoperative screening
- Operation due to case of emergency, polytrauma or pathologic fracture
- American Society of Anaesthesiologists (ASA) classification greater than III
- Peripheral or central edema
- AIDS (according to the CDC-classification of HIV-infection: category C)
- Immunosuppression therapy
- History of bleeding tendency (e.g. von-Willebrand-disease, thrombocytopenia)
- Derailed metabolic disorder (e.g. Diabetes mellitus (Glucose > 300 mg/dl) during the preoperative screening)
- Known history of electrolyte disturbance (e.g. Hyperkalemia > 5.8 mmol/l, Hypernatraemia > 155 mmol/l)
- Known history of acid-base-dysbalances
- History of intracranial hemorrhage within one year of participation in the study
- Neurological or psychiatric disease with limited contractual capability
- CHF (congestive heart failure) according to (New York Heart Association) classification - NYHA class IV
- Liver disease (CHILD B or C cirrhosis, end-stage liver disease (MELD-score greater than 10)
- Renal insufficiency (serum creatinine greater than 2.0 mg/dl or greater than 150 µmol/l or dependency of haemodialysis)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Diagnostique
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Comparateur actif: standard 2D ultrasound images
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higher ultrasound frequencies, better image resolution, better post-processing and user-friendliness.
current standard in two-dimensional (2D) ultrasound images
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Expérimental: high-quality 2D ultrasound images
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higher ultrasound frequencies, better image resolution, better post-processing and user-friendliness.
current standard in two-dimensional (2D) ultrasound images
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Comparateur actif: nerve stimulation techniques
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higher ultrasound frequencies, better image resolution, better post-processing and user-friendliness.
current standard in two-dimensional (2D) ultrasound images
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
|---|---|
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Reduction in time to perform the catheter placement in regional anesthesia
Délai: first three days
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first three days
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Mesures de résultats secondaires
Mesure des résultats |
Délai |
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Improvement in performance: Incidence of complications
Délai: first three days
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first three days
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Improvement of success rate regarding correct catheter placement
Délai: first three days
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first three days
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- eZono
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