Axillary Plexus Block in a High Resolution MRI

Diakonhjemmet Hospital

Status and phase: Completed; Phase 2

Conditions: Nerve Block; Magnetic Resonance Imaging

Treatments: Procedure: Active Comparator: Arm 2: transarterial injection; Procedure: Active Comparator: Arm 3: catheter and transarterial injection; Procedure: Active Comparator: Arm 1: catheter injection

Study type: Interventional

Funder types: Other

Identifiers

NCT01033006

S-04115

Details and patient eligibility

About

Background and aims:

Magnetic resonance imaging (MRI) has proved beneficial for presenting anatomy for regional anaesthesia and to demonstrate spread of local anaesthetic.

A new axillary plexus block with a triple injection (1), combining a short axillary catheter method with a transarterial axillary block, is now being evaluated with a 3 Tesla MRI. In this study, the investigators are investigating MR visualisation of three different block techniques and compare the clinical efficacy of the techniques, with the MR findings.

Patients & Methods:

After obtaining approval of the protocol from the regional ethical committee, 3 x 15 adult patients, scheduled for hand surgery, were included in a randomised, blinded prospective study.

Full description

After obtaining approval of the protocol from the regional ethical committee, 3 x 15 adult patients, scheduled for hand surgery, were included in a randomised, blinded prospective study.

In all patients a short axillary plexus catheter is positioned close to the median nerve using nerve stimulator.

Technique 1 = 40 ml in catheter Technique 2 = 30 ml behind and 10 ml in front of the brachial artery (BA) Technique 3 = 20 ml behind, 10ml in front of the BA and 10 ml in catheter

Clinical High Field MRI (3T) scanner has simplified the recognition of brachial plexus nerves in the axilla. After injection of local anaesthetic (LA), the identification of the nerve structures is nevertheless difficult. When all nerves are surrounded of LA in the axilla (MRI), it seems to be associated with a clinical complete brachial plexus block

Enrollment: 45 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients scheduled for hand surgery
• ASA 1 - 2
• Weight from 50 - 95 kg
• MR compatible, suitable

Exclusion criteria

• Neurologic deficit
• Reaction to LA

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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45 participants in 3 patient groups

Arm 1: catheter injection

Active Comparator group

Description:

40 ml of LA through the catheter

Treatment:

Procedure: Active Comparator: Arm 1: catheter injection

Arm 2: transarterial injection

Active Comparator group

Description:

30 ml deep and 10 ml superficial to the artery

Treatment:

Procedure: Active Comparator: Arm 2: transarterial injection

Arm 3: catheter and transarterial injection

Active Comparator group

Description:

20 + 10 ml transarterial block and 10 ml through the catheter

Treatment:

Procedure: Active Comparator: Arm 3: catheter and transarterial injection