Lumbosacral Erector Spinae Plane Block Versus Psoas Muscle Compartment With Sciatic Nerve Block for Anesthesia for Unilateral Lower Limb Operations in Critically Ill Patients

Tanta University

Status: Completed

Conditions: Lumbosacral; Lower Limb; Sciatic Nerve Block; Erector Spinae Plane Block; Psoas Muscle Compartment Block; Critically Ill Patients; Unilateral; Anesthesia

Treatments: Drug: Psoas Muscle Compartment With Sciatic Nerve Block; Drug: Lumbosacral Erector Spinae Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06580704

36264PR761/7/24

Details and patient eligibility

About

This study aims to compare lumbosacral erector spinae plane block and psoas muscle compartment with sciatic nerve block in unilateral lower limb operations in critically ill patients.

Full description

The lower limb surgeries are associated with acute postoperative pain and require long-term analgesia. Regional anesthesia is often used to prevent postoperative pain. Ultrasound-guided regional anesthetic approaches provide a simple intraoperative pathway that lowers pain scores with less impact on the respiratory or cardiovascular system.

Psoas compartment block (PCB) is a peripheral regional technique of anesthesia, which provides a block of the main components of the lumbar plexus - the femoral, lateral cutaneous nerve of the femur and sciatic nerve. In combination with the sciatic nerve block, the psoas compartment block provides effective anesthesia of the entire lower extremity, with better hemodynamic stability.

The erector Spinae plane block (ESPB) is a novel regional block technique primarily introduced in 2016 for managing severe neuropathic pain.

Enrollment: 130 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

• Age from 18 to 65 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status III, IV.
• Critically ill patients admitted to intensive care unit.
• Undergoing unilateral lower limb operations.

Exclusion Criteria:

• History of allergy to local anesthetics.
• Bleeding tendency.
• Coagulopathy.
• Anticoagulant therapy.
• Pre-existing psychological, neurologic, and spinal cord diseases.
• Previous back surgery.
• Infection or mass at the site of the block.
• Chronic analgesic therapy.
• Severe cardiac or renal diseases.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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130 participants in 2 patient groups

Lumbosacral Erector Spinae Plane Block

Experimental group

Description:

Patients will receive ultrasound-guided lumbosacral erector spinae plane block.

Treatment:

Drug: Lumbosacral Erector Spinae Plane Block

Psoas Muscle Compartment With Sciatic Nerve Block

Experimental group

Description:

Patients will receive ultrasound-guided psoas muscle compartment with sciatic nerve block.

Treatment:

Drug: Psoas Muscle Compartment With Sciatic Nerve Block