Changes in Vessels After Peripheral Block

Başakşehir Çam & Sakura City Hospital

Status: Completed

Conditions: Postoperative Pain; Anesthesia, Local; Vena Cava Syndrome (Inferior) (Superior); Fluid Loss

Treatments: Diagnostic Test: Inferior vena cava diameter <1.5 cm and Vena Cava Inferior Collapsibility Index (VCI-CI) > 50%; Procedure: Inferior vena cava diameter >1.5 cm and Vena Cava Inferior Collapsibility Index (VCI-CI) < 50%; Procedure: Lateral Sagittal Infraclavicular Block

Study type: Observational

Funder types: Other

Identifiers

NCT05968105

KAEK/2023.06.260 (Other Identifier)

e.mendes - 3

Details and patient eligibility

About

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.

Full 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.

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

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

Trial design

60 participants in 2 patient groups

Group 1

Description:

Inferior vena cava diameter \<1.5 cm and VCI-CI \> 50% according to Vena Cava Inferior Collapsibility Index (VCI-CI)

Treatment:

Diagnostic Test: Inferior vena cava diameter <1.5 cm and Vena Cava Inferior Collapsibility Index (VCI-CI) > 50%

Procedure: Lateral Sagittal Infraclavicular Block

Group 2

Description:

Inferior vena cava diameter \>1.5 cm and VCI-CI \< 50% according to Vena Cava Inferior Collapsibility Index (VCI-CI)

Treatment:

Procedure: Inferior vena cava diameter >1.5 cm and Vena Cava Inferior Collapsibility Index (VCI-CI) < 50%

Procedure: Lateral Sagittal Infraclavicular Block