Clinical trial NCT05968105: Changes in Vessels After Peripheral Block
Official title: Evaluation of Lateral Sagittal Infraclavicular Block According to Vena Cava Inferior Collapsibility Index (VCI-CI): An Observational Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Anesthesia, Local
Vena Cava Syndrome (Inferior) (Superior)
Fluid Loss
Postoperative Pain
Keywords: Vena Cava Inferior Collapsibility Index
Lateral Sagittal Infraclavicular Block
VCI-CI
Lead sponsor: Başakşehir Çam & Sakura City Hospital
Sponsor class: OTHER_GOV
First posted: 2023-08-01
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Block differences will be observed when patients who undergo routine hand surgery operations under the lateral sagittal infraclavicular block are classified according to the Vena Cava Inferior - Collapsibility Index.

Brief summary: In patients with fluid deficit, vasoconstriction occurs in peripheral tissues and blood circulation is kept in the central area. It causes arterial vasodilation and hemodynamic variability by increasing the blood volume of the extremity due to the sympathectomy occurring after the block. When the investigators classify patients according to VCI-CI, it will be questioned whether there is a difference between patients' block quality and hemodynamic variability.

Detailed description: VCI-CI helps us to have an idea about the amount of fluid in patients according to the vena cava Inferior (VCI) diameter and the diameter between the inspiring and expiration. Low arterial diameter and high inspiratory and expiratory variability indicate that the patient's fluid volume may be lower.

In the measurement of VCI diameter, VCI has visualized in the craniocaudal plane thanks to the transverse ultrasound probe. Changes in VCI diameter are observed depending on the negative pressure in the thoracic area during inspiration and expiration. When the difference between this rate of change is greater than 50%, it indicates that the patient has a fluid deficit. The fact that the VCI diameter is also below 1.5 cm indicates that this amount of fluid requirement is more serious. In this study, the investigators will question whether there is a difference between patients' block quality and hemodynamic variability when they classify patients according to VCI-CI.

Eligibility criteria: Inclusion criteria:

* Hand and Wrist elective surgery
* Infraclavicular block will be applied
* American Society of Anesthesiologists (ASA) physical condition I-II
* Patients aged 18-65 years

Exclusion Criteria:

* Contraindication for central or peripheral blocks
* Cognitive dysfunction
* History of chronic opioid use
* severe organ dysfunction
* Allergy to any drug used in the study
* Body mass index (BMI) ≥30
* Infection in the area to be treated
* Refusal to participate in the research

Primary outcomes:
measure: Doppler flow change from baseline to postoperative period
timeFrame: Perioperative period
Secondary outcomes:
measure: VAS (Visual Analog Scala) score
timeFrame: Postoperative 24th hour
measure: Analgesic consumption
timeFrame: Postoperative 24th hour
measure: Postoperative nausea and vomiting
timeFrame: Postoperative 24th hour
Other outcomes:
Locations:
city: Küçükçekmece
country: Turkey
facility: Ergun Mendes
state: İ̇stanbul
Study officials:
affiliation: Başakşehir Çam & Sakura City Hospital
name: Ergun Mendes
role: PRINCIPAL_INVESTIGATOR
References:
citation: Zhang H, Yuan H, Yu H, Zhang Y, Feng S. Correlation between pleth variability index and ultrasonic inferior vena cava-collapsibility index in parturients with twin pregnancies undergoing cesarean section under spinal anesthesia. Eur J Med Res. 2022 Aug 6;27(1):139. doi: 10.1186/s40001-022-00771-3.