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Axillary Plexus Block in a High Resolution MRI

2014-08-27 03:17:13 | BioPortfolio

Summary

Background and aims:

Magnetic resonance imaging (MRI) has proved beneficial for presenting anatomy for regional anaesthesia and to demonstrate spread of local anaesthetic.

A new axillary plexus block with a triple injection (1), combining a short axillary catheter method with a transarterial axillary block, is now being evaluated with a 3 Tesla MRI. In this study, the investigators are investigating MR visualisation of three different block techniques and compare the clinical efficacy of the techniques, with the MR findings.

Patients & Methods:

After obtaining approval of the protocol from the regional ethical committee, 3 x 15 adult patients, scheduled for hand surgery, were included in a randomised, blinded prospective study.

Description

After obtaining approval of the protocol from the regional ethical committee, 3 x 15 adult patients, scheduled for hand surgery, were included in a randomised, blinded prospective study.

In all patients a short axillary plexus catheter is positioned close to the median nerve using nerve stimulator.

Technique 1 = 40 ml in catheter Technique 2 = 30 ml behind and 10 ml in front of the brachial artery (BA) Technique 3 = 20 ml behind, 10ml in front of the BA and 10 ml in catheter

Clinical High Field MRI (3T) scanner has simplified the recognition of brachial plexus nerves in the axilla. After injection of local anaesthetic (LA), the identification of the nerve structures is nevertheless difficult. When all nerves are surrounded of LA in the axilla (MRI), it seems to be associated with a clinical complete brachial plexus block

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment

Conditions

Nerve Block

Intervention

Axillary plexus block and MRI

Location

The Interventional Centre, Rikshospitalet, Oslo University Hospital
Oslo
Norway
0027

Status

Enrolling by invitation

Source

Diakonhjemmet Sykehus

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:17:13-0400

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Medical and Biotech [MESH] Definitions

Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.

A blocking of NEURAL CONDUCTION in the network of nerve fibers innervating the UPPER EXTREMITY.

A blocking of NEURAL CONDUCTION in the network of nerve fibers innervating the neck and shoulder.

Impaired conduction of cardiac impulse that can occur anywhere along the conduction pathway, such as between the SINOATRIAL NODE and the right atrium (SA block) or between atria and ventricles (AV block). Heart blocks can be classified by the duration, frequency, or completeness of conduction block. Reversibility depends on the degree of structural or functional defects.

A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016).

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