Minimum Effective Volume for Selective Trunk Block

The Chinese University of Hong Kong

Status: Completed

Conditions: Musculoskeletal Diseases or Conditions

Treatments: Drug: a 1: 1 mixture of 2% lidocaine with 5ug/ml epinephrine and 0.5% levobupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT04773405

SeTB MEV Ver 4

Details and patient eligibility

About

The objective of this study is to identify the minimum effective dosage of a mixture of two local anaesthetic drugs called 'levobupivacaine' and 'lignocaine with epinephrine" used to produce an effective ultrasound guided selective trunk block for surgical anaesthesia of the upper limb.

Full description

Ultrasound is widely used for brachial plexus block (BPB) and current evidence indicates that it is feasible to accurately identify majority of the main components of the brachial plexus above the clavicle, including the three trunks. Since majority of the innervation to the upper extremity, including the shoulder, arises from the three trunks (superior, middle and inferior) of the brachial plexus, so targeted injections of the individual trunks of the brachial plexus under ultrasound guidance will produce surgical anaesthesia of the entire upper extremity (C5-T1). Principal Investigator refers to this novel technique "selective trunk block" (SeTB) and the preliminary experience with SeTB for surgical anaesthesia of the entire upper extremity has been very encouraging. Currently there are no data describing an optimal dose or volume of local anaesthetic for SeTB. The aim of this study is to identify the minimum dosage of 1:1 mixture of 'levobupivacaine' and "lignocaine with epinephrine" required to produce effective surgical anaesthesia in at least 90% of patients presented for upper limb surgery.

Enrollment: 25 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiologists (ASA) physical status I-III scheduled to undergo elective upper extremity surgery involving the proximal humerus to distal hand or surgery involving any combination of these regions.

Exclusion criteria

• Patient refusal
• pregnancy
• skin infection at the site of block placement
• history of allergy to local anaesthetic drugs
• history of bleeding tendency or with evidence of coagulopathy
• pre-existing neurological deficit
• pre-existing neuromuscular disease.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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25 participants in 1 patient group

Selective Trunk Block

Other group

Description:

Selective trunk block will be done under ultrasound guidance to patients scheduled for upper extremities surgeries. Local anaesthetic agents (a 1:1 mixture of 2% lidocaine with 5ug/ml of epinephrine and 0.5% levobupivacaine) will be injected at the superior, middle, and inferior trunks of the brachial plexus in order to anaesthetize the whole upper limb.

Treatment:

Drug: a 1: 1 mixture of 2% lidocaine with 5ug/ml epinephrine and 0.5% levobupivacaine