Protective Nerve Stimulation in Regional Anesthesia

NCT ID: NCT03291691

Last Updated: 2022-02-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-09-20

Study Completion Date

2023-12-31

Brief Summary

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Peripheral nerve blocks can be conducted with ultrasound, electrical nerve stimulation or landmark technique or a combination of this techniques. Whether a regional block should be conducted with a combination of those different possibilities is highly discussed. In this study the investigators want to show the effectiveness of new standard way of combined use of ultrasound and nerve stimulation, they call protective nerve stimulation. According to ethical vote we are conducting an observational study.

Detailed Description

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All patients will get the regional block they need for the elective surgery. Before starting the block a standard monitoring will be established. After applying the monitoring the block will be performed by an experienced anesthetist in supervision of another experienced anesthetist. The nerve stimulator is set on a fixed current of 1.0 mA and a block without motoric response on this current is tried. Ultrasound images are saved. After performing the regional anesthesia the further anesthetic procedure will be carried out and the surgery will take place. After surgery the patients will be transported to the recovery room or Postanesthesia care unit.

Conditions

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Anesthesia, Local Nerve Block Brachial Plexus Block

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Standard of care: SCI

Patients at Charite, with lower limb surgery undergoing a protective performed ultrasound guided sciatic nerve block. N=15.

No interventions assigned to this group

Standard of care: FEM

Patients at Charite, with lower limb surgery undergoing a protective performed ultrasound guided femoral nerve block. N=15.

No interventions assigned to this group

Standard of care: ISB

Patients at Charite, with upper limb surgery undergoing a protective performed ultrasound guided interscalene plexus block. N=15.

No interventions assigned to this group

Standard of care: AXP

Patients at Charite, with upper limb surgery undergoing a protective performed ultrasound guided axillary plexus block. N=15.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* written informed consent
* age of 18 or older
* elective surgery patients at Campus Charité Mitte with clinical benefit of regional anesthesia

Exclusion Criteria

* existing contraindication for regional nerve blocks or the use of Protective Nerve Stimulation
* patients who undergo outpatient treatment
* allergy against local anesthetics
* age under 18 years
* Lacking willingness to take part in the study
* ASA PS score of 4 or more
* preexisting neural damage in the effect area
* Diabetes mellitus, alcohol use disorder
* Participation in other prospective clinical interventional trials
* Accommodation in an institution due to an official or judicial order
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Responsible Party

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Jurgen Birnbaum

Principal Investigator and Consultant of the Department of Anesthesiology and Operative Intensive Care Medicine, CCM and CVK

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jürgen Birnbaum, MD

Role: PRINCIPAL_INVESTIGATOR

Charite University, Berlin, Germany

Locations

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Charité - Universitätsmedizin Berlin Campus Charité Mitte

Berlin, , Germany

Site Status

Countries

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Germany

References

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Salem MH, Winckelmann J, Geiger P, Mehrkens HH, Salem KH. Electrostimulation with or without ultrasound-guidance in interscalene brachial plexus block for shoulder surgery. J Anesth. 2012 Aug;26(4):610-3. doi: 10.1007/s00540-012-1366-x. Epub 2012 Mar 4.

Reference Type BACKGROUND
PMID: 22391670 (View on PubMed)

Klaastad O, Sauter AR, Dodgson MS. Brachial plexus block with or without ultrasound guidance. Curr Opin Anaesthesiol. 2009 Oct;22(5):655-60. doi: 10.1097/ACO.0b013e32832eb7d3.

Reference Type BACKGROUND
PMID: 19550303 (View on PubMed)

Dillane D, Tsui BC. Is there still a place for the use of nerve stimulation? Paediatr Anaesth. 2012 Jan;22(1):102-8. doi: 10.1111/j.1460-9592.2011.03729.x. Epub 2011 Nov 4.

Reference Type BACKGROUND
PMID: 22050512 (View on PubMed)

Vassiliou T, Muller HH, Limberg S, De Andres J, Steinfeldt T, Wiesmann T. Risk evaluation for needle-nerve contact related to electrical nerve stimulation in a porcine model. Acta Anaesthesiol Scand. 2016 Mar;60(3):400-6. doi: 10.1111/aas.12664. Epub 2015 Dec 15.

Reference Type BACKGROUND
PMID: 26666693 (View on PubMed)

Dexter F, Candiotti KA. Multicenter assessment of the Iowa Satisfaction with Anesthesia Scale, an instrument that measures patient satisfaction with monitored anesthesia care. Anesth Analg. 2011 Aug;113(2):364-8. doi: 10.1213/ANE.0b013e318217f804. Epub 2011 Apr 25.

Reference Type BACKGROUND
PMID: 21519043 (View on PubMed)

Wiesmann T, Borntrager A, Vassiliou T, Hadzic A, Wulf H, Muller HH, Steinfeldt T. Minimal current intensity to elicit an evoked motor response cannot discern between needle-nerve contact and intraneural needle insertion. Anesth Analg. 2014 Mar;118(3):681-6. doi: 10.1213/ANE.0b013e3182a94454.

Reference Type BACKGROUND
PMID: 24284806 (View on PubMed)

Wiesmann T, Steinfeldt T, Exner M, Nimphius W, De Andres J, Wulf H, Schwemmer U. Intraneural injection of a test dose of local anesthetic in peripheral nerves - does it induce histological changes in nerve tissue? Acta Anaesthesiol Scand. 2017 Jan;61(1):91-98. doi: 10.1111/aas.12825. Epub 2016 Oct 25.

Reference Type BACKGROUND
PMID: 27778324 (View on PubMed)

Sen O, Sayilgan NC, Tutuncu AC, Bakan M, Koksal GM, Oz H. Evaluation of sciatic nerve damage following intraneural injection of bupivacaine, levobupivacaine and lidocaine in rats. Braz J Anesthesiol. 2016 May-Jun;66(3):272-5. doi: 10.1016/j.bjane.2014.09.012. Epub 2015 Mar 12.

Reference Type BACKGROUND
PMID: 27108824 (View on PubMed)

Brull R, McCartney CJ, Chan VW, El-Beheiry H. Neurological complications after regional anesthesia: contemporary estimates of risk. Anesth Analg. 2007 Apr;104(4):965-74. doi: 10.1213/01.ane.0000258740.17193.ec.

Reference Type BACKGROUND
PMID: 17377115 (View on PubMed)

Other Identifiers

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ProNerv

Identifier Type: -

Identifier Source: org_study_id

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