Clinical trial NCT00988234: Comparison of Two Position for Ultrasound Guided Lumbar Plexus and Sciatic Nerve Block
Official title: Comparison of Lateral Decubitus Position Versus Prone Position for Ultrasound Guided Posterior Lumbar Plexus Block and Sciatic Nerve Block
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Lower Limb Surgery
Keywords: Lumbar plexus block
sciatic nerve block
position
ultrasound guidance
elective lower limb surgery
Lead sponsor: Huazhong University of Science and Technology
Sponsor class: OTHER
First posted: 2009-10-02
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: In the present study, the investigators will test the effect of two position on posterior lumbar plexus and subgluteal or sub-greater trochanter sciatic nerve block.

Detailed description: The posterior lumbar plexus block approach was described approximately 30 years ago, using surface anatomical landmarks and a loss-of-resistance technique, but over the years it was almost abandoned for its low successful rate, the huge numbers of adverse effects and its difficulties to be performed. The introduction of the nerve stimulator and ultrasound guided technique in recent years increased the success rate in various peripheral nerve blocks and decreased adverse effects. Ultrasound guided LPB as well as sciatic nerve block technique in a small patient population resulting in a encouraging result, but published clinical data on optimal patient position for ultrasound-guided LPB are limited. We designed this prospective randomized study to compare the success rate, time of performance and complications of ultrasound guided posterior lumbar plexus block as well as subgluteal or sub-greater trochanter sciatic nerve block under lateral decubitus position v.s. prone position.

Eligibility criteria: Inclusion Criteria:

* 18 to 75 years old
* elective unilateral lower limb surgery
* ASA Physical Status ASA I-III

Exclusion Criteria:

* age \<18 or \>75 year old
* ASA Physical Status \>ASA III
* abnormal blood coagulation
* infection near puncture place
* nerve injury
* bilateral lower limb surgery
* patients with lumbar vertebral trauma
* inability to be properly positioned
* chronic narcotic therapy or illicit drug use

Primary outcomes:
measure: Block success defined as loss of sensation to pinprick in each of the lumbar plexus and sciatic nerve distributions when measured 30 min after block performance.
timeFrame: 30min
measure: Motor blockade was evaluated by assessing the strength of knee extension (femoral nerve), thigh adduction (obturator nerve), and plantar flexion and dorsiflexion of the ankle (sciatic nerve) 30 min after block performance.
timeFrame: 30min
Secondary outcomes:
measure: block execution time, depth of the nerve, needle depth, duration of the sensory and motor blockade, complications such as inadvertent needle puncture of epidural space, dural puncture, peritoneal puncture, and kidney or ureter puncture and nerve injury.
timeFrame: within 48h
Other outcomes:
Locations:
city: Wuhan
country: China
facility: Department of Anaesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology
state: Hubei
Study officials:
affiliation: Department of Anaesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology
name: Yuke Tian, MD.
role: STUDY_CHAIR
References: