Continuous Sciatic Block Nerve in the Management of Vascular Pain in Critical Ischemia of Lower Limbs Patients

Study Overview
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Brief Summary
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Critical limb ischemia (CLI) is associated with severe pain that is a therapeutic challenge whit therapeutic limits for the use of conventional analgesics medications. ultrasound-guided continuous sciatic block (CCBN) is strategy effective and safe to consider in this patients. This prospective descriptive exploratory cohort study evaluates CCBN as a effective therapeutic tools for patients whit (CLI)

Detailed Description
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Critical limb ischemia is the final stage of peripheral vascular disease identified by resting pain greater than 2 weeks with ulcers or gangrene in 1 or both extremities. Pain relief is a therapeutic challenge due to its severity, which significantly affects the quality of life, and the comorbidities that occur frequently in these patients, which limits the use of analgesics medications. Regional techniques can play an important role as they are safe and effective in analgesic management . Within these we find the ultrasound guided continuous sciatic block as a strategy to consider in the periods of exacerbation of pain, as a bridge to a palliative or resolutive management. Prospective descriptive exploratory cohort study. Patients with a diagnosis of critical ischemia of the lower limb with severe pain and side effects of opioids will be included. A continuous ultrasound-guided sciatic nerve block with longitudinal approach will be performed, with no anti-aggregation or anticoagulation suspension, continuing with an infusion of Bupivacaine 0.1% The primary outcome will be numerical pain rating scale (NPrs) and secondary outcome Pinprick test, catheter duration, opioid consumption reduction and side effects to it.

Official Title
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Evaluation of Ultrasound Guided Continuous Sciatic Block Nerve With a Longitudinal Approach in the Management of Vascular Pain in Critical Ischemia of Lower Limbs Patients : Prospective Descriptive Study of Exploratory Cohort

Conditions
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Critical Limb Ischemia

Intervention / Treatment
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* Procedure: ultrasound-guided continuous sciatic block with longitudinal approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with a diagnosis of critical ischemia of the lower limb with severe pain and side effects of opioids Exclusion Criteria: Under 18 years old

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: ultrasound-guided continuous sciatic block with longitudinal approach|ultrasound-guided continuous sciatic block with longitudinal approach|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain level measurement with Numeric Rate Score (NRS) | 0-10 where 0 means no pain and 10 means maximum possible pain | 5 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pinprick test | evaluation of superficial sensitivity in S1 dermatome positive or negative | 5 days | 
| catheter duration | number of days in which the catheter is functional | 5 days | 
| opioid consumption reduction | opioid consumption in morphine equivalence | 5 days | 
| Delirium | minimental test score from 0 to 30 points. Delirium positive for less than 24 | 5 days | 
| Nauseas and Vomit | yes or not present | 5 days |