Lumbar Plexus Block Application in Ultrasound-guided Shamrock Method

Study Overview
=================
Brief Summary
-----------------
The more effective use of ultrasound in regional anaesthesia techniques has made different block applications possible. Lumbar plexus block is also used for post-operative analgesia and surgical anaesthesia. Currently, in-plane ultrasound-guided LPB is widely used in short-axis imaging and Shamrock imaging.

Detailed Description
-----------------
The purpose of this use is to investigate the effectiveness of lumbar plexus block application applied with in-plane and out-of-plane methods accompanied by Shamrock imaging.

Official Title
-----------------
Investigation of the Efficacy of Different Types of Lumbar Plexus Block Applied With Ultrasound-guided Shamrock Method

Conditions
-----------------
Femoral Neck Fractures, Lumbosacral Plexus, Nerve Block

Intervention / Treatment
-----------------
* Procedure: in-plane needle guidance
* Procedure: out-of-plane needle guidance


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 18-90 years old ASA (American Society of Anaesthesiologist) Score I-III risk class Patients who will undergo femoral neck fracture operation. Exclusion Criteria: Local Anaesthetic Allergy With Bleeding Diathesis Disorder Mental Disorders Allergic to the medicines used Previous Cerebrovascular Disease Body Mass Index above 30

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: in-plane needle guidance<br>Ultrasound -guided lumbar plexus block | Procedure: in-plane needle guidance<br>* Ultrasound -guided lumbar plexus block with in-plane needle guidance using the Shamrock method<br>|
| Active Comparator: out-of-plane needle guidance<br>Ultrasound -guided lumbar plexus block | Procedure: out-of-plane needle guidance<br>* Ultrasound -guided lumbar plexus block with out-of-plane needle guidance using Shamrock method<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Block application time | The stopwatch will be started by another researcher with the needle skin penetration and the stopwatch will be stopped as soon as the needle leaves the skin. | up to 20 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of interventions | intervention from the same or another site after exiting the skin | up to 20 minutes | 
| The number of needle guidance | Retraction and re-advancement of the needle after skin entry without exiting the skin | up to 20 minutes | 
| sensory block | Both lower limbs sensory block time after the applied block will be evaluated by pinprick and cold test (10.15., 20., 25., 30., 35. and 40 minutes). | up to 40 minutes | 
| motor block | Both lower limbs Modified Bromage scale was used to evaluate motor block. Modified Bromage scale 0 No motor block Raises the knee in flexion Raises the ankle Full block, can't move his foot | up to 40 minutes |