Continuous Infraclavicular Nerve Blocks: Needle Versus Catheter Local Anesthetic Bolus
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Purpose
The investigators propose to test the hypothesis that when placing a perineural catheter for a continuous peripheral nerve block, injecting the initial local anesthetic bolus via the insertion needle results in a faster-onset sensory block than injecting the initial bolus via the perineural catheter. The study results will help define the optimal local anesthetic bolus introduction technique—needle versus catheter—for peripheral nerve blocks when placing a perineural catheter.
| Condition | Intervention | Phase |
|---|---|---|
|
Nerve Block |
Procedure: Local Anesthetic given via perineural catheter for infraclavicular nerve block. Procedure: Local Anesthetic given via needle for infraclavicular nerve block |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Continuous Infraclavicular Nerve Blocks: Needle Versus Catheter Local Anesthetic Bolus |
- Sensory Level [ Time Frame: 120 minutes ] [ Designated as safety issue: No ]EKG pads will be positioned in the 5 major nerve distributions distal to the elbow, ensuring placement is equivalent bilaterally. The primary endpoint will be the time, in minutes, until all 5 nerve territories record > 60 mA, or 120 minutes—whichever occurs first—since 60 mA is estimated to be equivalent to a surgical incision.
- Grip Strength [ Time Frame: 120 Minutes ] [ Designated as safety issue: No ]Evaluated using a portable isometric force dynamometer to measure the maximum voluntary isometric contraction (MVIC) of the hand/fingers. Subjects will be asked to take 2 sec to come to maximum effort, maintain this effort for 3 sec, and then relax.
- Sensory level for individual nerves [ Time Frame: 120 Minutes ] [ Designated as safety issue: No ]Evaluated using transcutaneous electrical stimulation (TES) in the same manner as described for the primary end point.
| Enrollment: | 0 |
| Study Start Date: | January 2013 |
| Study Completion Date: | January 2013 |
| Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Local Anesthetic Via Catheter
30mL of Lidocaine (local Anesthetic) will be injected via a perineural catheter at hour 0.
|
Procedure: Local Anesthetic given via perineural catheter for infraclavicular nerve block.
Patients will be randomized to receive 30mL of Lidocaine via Catheter for an infraclavicular nerve block on one side (right or left) and via needle on the other side. Sensory and strength will be tested following local anesthetic administration.
|
|
Active Comparator: Local Anesthetic Via Needle
30mL of Lidocaine (local Anesthetic) will be injected via a needle at hour 0.
|
Procedure: Local Anesthetic given via needle for infraclavicular nerve block
Patients will be randomized to receive 30mL of Lidocaine via Catheter for an infraclavicular nerve block on one side (right or left) and via needle on the other side. Sensory and strength will be tested following local anesthetic administration.
|
Detailed Description:
Specific Aim: The investigators propose to test the hypothesis that when placing a perineural catheter for a continuous peripheral nerve block, injecting the initial local anesthetic bolus via the insertion needle results in a faster-onset sensory block than injecting the initial bolus via the perineural catheter. The study results will help define the optimal local anesthetic bolus introduction technique—needle versus catheter—for peripheral nerve blocks when placing a perineural catheter.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- age ≥ 18 years
- willing to have bilateral infraclavicular blocks/catheters placed
Exclusion Criteria:
- current daily analgesic use
- opioid use within the previous 4 weeks
- any neuro-muscular deficit of either upper extremity
- body mass index > 30 kg/m2
- weight < 50 kg [100 lbs]
- pregnancy
- incarceration
Contacts and Locations| United States, California | |
| UCSD CTRI, Hillcrest | |
| San Diego, California, United States, 92103 | |
| Principal Investigator: | Brian M Ilfeld, M.D., M.S. | University of California, San Diego |
More Information
No publications provided
| Responsible Party: | Brian M. Ilfeld, MD, MS, Associate Professor, In Residence, University of California, San Diego |
| ClinicalTrials.gov Identifier: | NCT01377545 History of Changes |
| Other Study ID Numbers: | Infraclav Needle vs Catheter |
| Study First Received: | June 17, 2011 |
| Last Updated: | January 16, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, San Diego:
|
Infraclavicular Nerve Block Needle Perineural Catheter |
Volunteer Upper Extremity Nerve Block Sensation Strength |
Additional relevant MeSH terms:
|
Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions |
Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 16, 2013