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Completed

NCT Number: NCT02589054

Regional Changes in Upper Limb Perfusion Following Brachial Plexus Block: A Pilot Study

Ultrasound-guided regional anesthesia is increasingly being used in the modern surgical environment to provide specific intraoperative anesthesia and postoperative analgesia. Infiltration of local anesthesics around peripheral nerves firs blocks sympathetic, then sensory, then motor nerve function. Sympathectomy-induced vasodilation following brachial plexus block results in increased skin temperature and arterial flow within minutes.

Although it has not been shown to reliably increase diameter or cross-sectional area of distal arteries, brachial plexus block does change the pattern and quantity of blood flow to the hand. Given that the magnitude of change of flow cannot be attributed to vessel radius, the investigators suspect that the more laminar fluid dynamics are due to vascular tone.

The investigators study aims to quantify alterations in physiology and peripheral vasodilator response. The investigators anticipate that axially block will significantly improve regional blood flow.

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Key information

Conditions

Anesthesia, Conduction Nerve Block Regional Blood Flow Sympathectomy

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Observational

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • ASA physical status I, II, III
  • BMI less than or equal to 39
  • Presenting for elective upper limb surgery
  • Does not meet any exclusion criteria

Exclusion criteria

  • Age over 80
  • ASA physical status IV or V
  • BMI greater or equal to 40
  • Language barrier precluding ability to give informed consent
  • History of coagulopathy
  • INR < 1.4
  • Platelet count < 100
  • Allergy to local anesthetics
  • Known peripheral vascular disease of the upper limbs
  • Amputation of one or both upper limbs, not including digits
  • Peripheral neurological disease
  • Does not consent to participate in study

Treatment and study plan

monitoring

Other

Primary outcomes

  1. Changes in regional blood flow and perfusion characteristics in the upper arm arteries from baseline to 20 minutes after unilateral axillary block.

    Time frame: 30 minutes

    Physiologic parameter

Secondary outcomes

  1. Changes in the caliber of the arteries of the arm between arms from baseline to 20 minutes after unilateral axillary block.

    Time frame: 30 minutes

    Physiologic parameter

  2. Changes in skin temperature between hands from baseline to 20 minutes after unilateral axillary block.

    Time frame: 30 minutes

    Physiologic parameter

  3. Sensory loss in radial, ulnar, and median nerve distribution between hands from baseline to 20 minutes after unilateral axillary block.

    Time frame: 30 minutes

    Physical examination

  4. Motor weakness in radial, ulnar, and median nerve distributions between hands from baseline to 20 minutes after unilateral axillary block

    Time frame: 30 Minutes

    Physical examination

Sponsors and collaborators

Lead sponsor

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Other

Collaborators

  • London Health Sciences Centre
  • St. Joseph's Health Care London
  • University of Western Ontario, Canada

Registry information

Acronym: RAFFAB

Important dates

Study start
2015
Primary completion
2016
Study completion
2016
First posted
Oct 28, 2015
Registry last updated
Mar 30, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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