Ultrasound Guided Blockade of the Lumbar Plexus - the Supra Sacral Parallel Shift (SSPS)

University of Aarhus

Status: Completed

Conditions: Hip Fracture

Treatments: Procedure: Lumbar plexus block using LUT technique; Procedure: Lumbar plexus block using SSPS technique

Study type: Interventional

Funder types: Other

Identifiers

NCT01669018

SSPS-1-10-72-366-12

Details and patient eligibility

About

Anesthesia for hip surgery can be performed with ultrasound guided blockade of the mesh of nerves (the lumbar plexus) supplying the hip region from the lumbar spinal nerves. This is a relevant technique in patients with severe cardiac comorbidity. The technique is a safer alternative compared to general or spinal anesthesia in these fragile patients.

The most recognized technique with ultrasound guidance (Karmakars technique) is technically demanding and based on injection of local anesthetic relatively close to the exit of the spinal nerves from the spine. The risk is spread of local anesthetic to the spinal canal prompting a risk of low blood pressure. This may be fatal in high risk patients.

The investigators have developed a simple technique based on injection away from the spinal canal. The investigators expect minimal risk of spread of local anesthetic to the spinal canal with this technique.

This randomized, double blinded trial compares the new technique to the established technique of ultrasound guided blockade of the lumbar plexus.

The hypothesis is that the new technique has a higher success rate with reduced effect on blood pressure for ultrasound guided lumbar plexus block compared to the established technique.

Enrollment: 20 patients

Sex: Male

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• written informed consent
• ASA I (American Society of Anesthesiologists physical status classification)

Exclusion criteria

• volunteers who are not able to cooperate
• volunteers who do not understand and speak danish
• daily use of analgesics
• allergy to local analgesics or contrast agents
• abuse of medicine or alcohol
• volunteers with technical impediments of the planned interventions

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Double Blind

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20 participants in 2 patient groups

Lumbar ultrasound trident (LUT)

Active Comparator group

Description:

Lumbar plexus block using LUT technique

Treatment:

Procedure: Lumbar plexus block using LUT technique

Supra Sacral Parallel Shift (SSPS)

Experimental group

Description:

Lumbar plexus block using SSPS technique

Treatment:

Procedure: Lumbar plexus block using SSPS technique