The Anterior Approach of the Combined Lumbar and Sacral Plexuses Block for Analgesia of Lower Limb Surgeries

Study Overview
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Brief Summary
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lumbosacral plexus block (LSPB) has been widely applied in orthopedics departments due to its advantages, including reduction in the application of opiates, decreasing the occurrence of acute pain, promoting early activation, and shortening the time of hospital stay. LSPB is a peripheral regional technique of anesthesia and analgesia, that provides a block of the main components of the lumbosacral plexus.

Detailed Description
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Traditional ultrasound-guided lumbar plexus block combined with sacral plexus block requires separate blocks at different sites, requiring the lateral decubitus or prone position, which may be suboptimal in patients with severe pain. we present an anterior approach for combined lumbar and sacral plexus blocks with a one-point puncture.

Official Title
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The One-Point Puncture Anterior Approach of the Combined Lumbar and Sacral Plexuses Block for Analgesia of Lower Limb Orthopedic Surgeries

Conditions
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Lower Limb Fracture

Intervention / Treatment
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* Procedure: combined Lumbar and sacral plexus block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients diagnosed with unilateral lower limb fracture by X-ray or CT examination patients with any contraindications to spinal anesthesia Exclusion Criteria: puncture site infection patients with coagulation disorders patients who refuse to participate or withdraw due to personal reasons allergy to local anesthetics.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Using a point puncture approach instead of two punctures to perform lumbosacral plexuses block in the interventional group
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Control group<br>patients who will be recruited in the control group will receive general anesthesia only | Procedure: combined Lumbar and sacral plexus block<br>* performing an ultrasound-guided combined Lumbar and sacral plexus block using one-point puncture<br>* Other names: No block intervention in control group;|
| Active Comparator: Interventional group<br>Patients who will be recruited in the Interventional will receive combined lumbar and sacral plexus block | Procedure: combined Lumbar and sacral plexus block<br>* performing an ultrasound-guided combined Lumbar and sacral plexus block using one-point puncture<br>* Other names: No block intervention in control group;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total intraoperative and postoperative opioid consumption | The total fentanyl doses consumed in the entire operative procedure and morphine consumed for 8 hours postoperative will be calculated. | Total fentanyl used intraoperative and total morphine consumed up to 8 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| (NRS) score assessment in the recovery room and then it will be repeated every 2 hours for 8 hours postoperatively | Numerical Pain Score (NRS) ranges from 0 to 10, where 0 is no pain, and 10 is the worst pain imaginable. Adequate pain control will be considered at Numerical Pain Score (NRS) < 4. Postoperative pain will be assessed using (the NRS) score first in the recovery room and then it will be repeated every 2 hours postoperatively for 8 hours after then. | postoperatively pain (NRS) score assessment for 8 hours |