Clinical trial NCT06913348: Ultrasound-Guided Sciatic Popliteal Nerve Block vs. Erector Spinae Plane Block in Endovascular Management of CLI
Official title: Ultrasound-Guided Sciatic Popliteal Nerve Block vs. Erector Spinae Plane Block in Patients Undergoing Endovascular Management of Critical Lower Limb Ischemia
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Critical Limb Ischemia (CLI)
Popliteal Nerve Block
ESPB
Keywords: popliteal nerve block
ESPB
Lead sponsor: Minia University Hospital
Sponsor class: OTHER
First posted: 2025-04-06
Enrollment: 70
Sex: ALL
Minimum age (years): 20
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Both sexes and from 20 to 80 years

Brief summary: Comparison of popliteal sciatic nerve block and erector spinae plane block (ESPB) in patients undergoing endovascular management of critical lower limb ischemia (CLI).

Detailed description: Nerve blocks, particularly regional anesthesia techniques, have been increasingly used in the endovascular management of critical lower limb ischemia (CLI). These techniques offer numerous advantages over general and local anesthesia.

Primary Advantages of Nerve Blocks:

1. Superior Pain Control

   Nerve blocks, such as femoral and sciatic nerve blocks, provide effective pain relief by anesthetizing the nerve supply to the lower limb.

   They offer more comprehensive analgesia than local anesthesia alone, as they numb the entire area around the puncture site.
2. Enhanced Patient Comfort

   Nerve blocks allow patients to remain pain-free during and after the procedure.

   They minimize discomfort even in lengthy or complex cases.
3. Reduction in Systemic Analgesic Requirements

   By providing localized anesthesia, nerve blocks significantly reduce the need for systemic analgesics, particularly opioids.

   This is essential because CLI patients often have comorbidities that make opioid use risky.
4. Fewer Opioid-Related Side Effects

   Nerve blocks reduce the incidence of opioid-related side effects, including nausea, vomiting, respiratory depression, and sedation.
5. Improved Hemodynamic Stability

Nerve blocks preserve autonomic nervous system function, reducing fluctuations in blood pressure and heart rate compared to general anesthesia.

This is especially beneficial for CLI patients, who frequently have underlying cardiovascular disease.

Eligibility criteria: Inclusion Criteria:

1. Patient age will be 20-70 years.
2. Patients will be diagnosed with critical lower limb ischemia by clinical presentations and investigations.
3. ASA physical status 2-3

Exclusion Criteria:

1. Patient refusal to participate in this study.
2. Patient inability to understand the scales or to describe to the investigators.
3. Coagulation disorder.
4. Sever renal or kidney dysfunction.
5. Taking opioids before admission.
6. Morbid obesity .

Primary outcomes:
measure: Block quality
timeFrame: Baseline (immediately after block administration).
Secondary outcomes:
measure: Postoperative Analgesia Duration
timeFrame: Up to 24 hours postoperatively.
Other outcomes:
Locations:
city: Minia
country: Egypt
facility: Minia university hospital
state: Minia governorate
Study officials:
affiliation: Minia University Hospital
name: Amr Nady Abd Elrazik, assistant professor
role: STUDY_DIRECTOR
References: