Clinical trial NCT01591603: Comparison of Perineural Catheter Depth for the Continuous Popliteal Nerve Block Using Ultrasound Guidance and Dermabond
Official title: Comparison of Perineural Catheter Depth for the Continuous Popliteal Nerve Block Using Ultrasound Guidance and Dermabond
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Neuromuscular Inhibition
Lead sponsor: Vanderbilt University
Sponsor class: OTHER
First posted: 2012-05-04
Enrollment: 83
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The study will investigate the difference in success rate between popliteal peripheral nerve catheters placed at 1 centimeter compared to 5 centimeters past the tip of a Tuohy needle.

Detailed description: Traditionally for the lower extremity, peripheral nerve catheters have been threaded greater than or equal to 5 centimeters past the tip of the Tuohy needle. The major rational for this practice is to reduce dislodgement. However, the greater the distance that a catheter is advanced, the greater the risk of contacting undesired structures, kinking, looping and knotting. For the continuous popliteal nerve block, the catheter is threaded perpendicular to the course of the nerve. This could result in the tip of the catheter being a significant distance from the targeted nerve which may lead to a decrease in the success rate or efficacy of the block.

Greater efficacy may be seen if the needle is closer to its target. This may be quantified by documenting a faster onset of motor and sensory changes and/or a lower catheter infusion rate required to maintain pain control. The study will investigate the difference in success rate between popliteal peripheral nerve catheters placed at 1 centimeter compared to 5 centimeters past the tip of a Tuohy needle.

Eligibility criteria: Inclusion Criteria:

* Will be having a popliteal nerve blocks
* Do not meet any of the exclusion criteria listed below.

Exclusion Criteria:

* \< 18 years old
* BMI \> 35
* Pregnant patients
* Diabetes mellitus or patients with known neuropathy
* Amputations \& polytrauma patients
* Patients allergic to local anesthetics
* Chronic Pain patients
* Patients in whom communication is a problem

Primary outcomes:
measure: Change in Peripheral block score (PBS).
timeFrame: 10, 20, and 30 minutes after intervention
Secondary outcomes:
measure: Pain score
timeFrame: Arrival to PACU (Immediately after surgery, approximately 3-5 hours after intervention)
measure: Analgesia failure rate
timeFrame: Arrival to PACU (Immediately after surgery, approximately 3-5 hours after intervention)
measure: Catheter dislodgement rates
timeFrame: Arrival to PACU (Immediately after surgery, approximately 3-5 hours after intervention)
measure: Difference in total opioid usage
timeFrame: Length of Stay In PACU (Approximately 5-7 hours after intervention)
measure: Degree of Doppler color agitation
timeFrame: Immediately after intervention
Other outcomes:
Locations:
city: Nashville
country: United States
facility: Vanderbilt University Medical Center
state: Tennessee
Study officials:
affiliation: Vanderbilt University Medical Center
name: Clifford Bowens, M.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bowens C Jr, Badiola IJ, Allen BFS, Canlas CL, Gupta RK, Jaeger LM, Briggs ER, Corey JM, Shi Y, Schildcrout JS, Malchow RJ. Color Doppler ultrasonography of an agitated solution is predictive of accurate catheter placement for a continuous popliteal sciatic nerve block. Perioper Med (Lond). 2021 Dec 15;10(1):59. doi: 10.1186/s13741-021-00229-w.